Trial day 20 of 28 · Tuesday · Rebuttal

August 25, 2026

Heilbrun's direct ends on criminal responsibility; the cross goes at his credentials, then at the medication year and the care she was given, and ends past noon on what psychosis did to her mind and how long after a birth it can begin. The Commonwealth's redirect follows at about half past twelve, first on how the opinion was built, then on the two things the cross had taken from it — the voice and the medication — and finally on the proposition the whole rebuttal rests on, that a mental disorder does not by itself answer the question the jury has. A short re-cross closes his evidence just after one, and the jury goes to lunch with one Commonwealth witness left.

Coverage: reported. Multiple outlets described this day's proceedings. This is a summary of press reporting, not a transcript and not a record of what anyone said. All trial days · This day at clancytrial.org

What mattered

Key points 16

THE SITTING IS OVER, AND THE LAST WITNESS IS PART-WAY THROUGH. Dr. Kirk Heilbrun's evidence is complete on the record — direct examination, cross, the Commonwealth's redirect and a short re-cross — and the jury went to lunch at about one o'clock. Court came back a little after two and the Commonwealth called Dr. Gregory Saathoff, the last witness it means to put on. His direct ran through his qualifications, his prison and hospital work, a paper of his from 1987 on drug-induced postpartum psychosis, and an account of what psychosis is and what causes it; it then turned to this case, to the records and video he reviewed, to the interviews he conducted with the defendant and with her husband, and to the account she gave him of the voice she heard on January 24. From the middle of the afternoon he was weighing that account rather than relaying it: a voice heard once, speaking without pause and unaccompanied by any delusion, is not what psychosis usually looks like, he told the jury, and carrying out what a command hallucination demands does not in his experience make it stop. He put a series of divergences to the jury — what the children were doing when her husband rang, when she first heard the voice, a mood stabilizer prescribed and filled in December 2022 and then not taken, how she described McLean and Spaulding against what those records show, and a phone that had her searching for the restaurant before she asked her husband about takeout at all. The last of it was her own attempt on her life, which he called serious and said had required a sequence of decisions taken one after another and had left out that she crushed the pills, and then her account of the killings themselves. The jury was sent home with him still under direct examination and no opinion of his on criminal responsibility reported. The charge and closing arguments below remain an advance expectation and may not survive contact with the days that are left.
TWELVE OUTLETS CARRY THE SITTING, AND MOST OF THEM STAYED WITH IT TO THE END. Nine reached the close of the day or close to it — the Boston Globe, NBC News, NBC Boston, Boston 25, the Patriot Ledger, East Idaho News, the Hearst Connecticut papers, the Boston Herald and Fox News. The Boston Globe is much the fullest of them on Dr. Saathoff and stayed furthest ahead for most of the afternoon: it is the only account of what he told the jury about the causes of psychosis, about the material he reviewed, and about the medications she was taking in 2013, the Lamictal discussion of December 2022, the prescription for it that she filled and did not take, how she described McLean Hospital to him, the Spaulding visit, the takeout order and the account she gave him of her own attempt on her life. Boston 25 is the only account to name the defense expert she gave the earlier version of the voice to, and the only one carrying the photographs from the scene as the prosecutor put them; it also names the medicine she sent her husband to collect and was first with the bench's schedule at the end of the day. NBC News is alone in setting his answers beside Dr. Heilbrun's on the same point, and alone in reporting why the lemonade in the wine tumbler mattered to him; Fox News, which stopped at 3:18, is alone in listing the providers to whom she never reported a voice. The Patriot Ledger and the Boston Herald are the only accounts to record him saying it is not typical to act at once on a voice, and the Ledger alone places the knife at the butcher block. East Idaho News, which is alone in recording that he is not board certified, added nothing for over an hour in the middle of the afternoon and then caught up through the close; it is the only account of the video of the children he was taken to. NBC Boston is the only account of his answer about her fear of losing the children, of the defense's request for a separate hearing on his qualifications, of his reason for weighing what a patient does and does not tell her clinicians, and of what she told him she could not remember about getting the children downstairs; it publishes its entries in a shortened form, so only what they carry is used here. On the morning, the Boston Globe is much the fullest account of the redirect and the re-cross, and NBC News the only account of the objection and sidebar that ended the re-cross; two of the latter's recess posts are written from the gallery rather than from the evidence. The Hearst Connecticut papers, whose account stopped at 3:46, share with the Boston Herald the record of Reddington putting an earlier report of Dr. Phillip Resnick's to the witness, and the two are the only accounts to break Dr. Saathoff's interview hours down by session — in figures that do not agree with each other. CBS Boston's day-20 page carries no timestamps of its own and covers the morning only. The Associated Press filed a story on Heilbrun's opinion that the defendant was criminally responsible and last revised it at about half past twelve. ABC News runs one live blog across sittings and filed a full account of Tuesday's direct examination late in the morning; it has nothing since. Boston 25 also keeps a separate day-20 page that sets up the sitting rather than reporting from inside it; boston.com's Tuesday page recounts Monday only. The Boston Herald's own day-20 blog, which was not available to this index while the sitting was running, could be read in the evening; it runs from the morning cross-examination through to 3:52 and is the only account of the two objections behind the afternoon sidebars, of the hospital criteria put to Dr. Heilbrun on cross, and of his declining a question on redirect that he said belonged to medicine.
HEILBRUN GAVE THE JURY THE OPINION THE REBUTTAL EXISTS FOR, AND THE COMMONWEALTH STOPPED THERE. Asked in terms whether she was criminally responsible under Massachusetts law, he answered that in his clinical opinion she was, and the direct examination ended on that answer (NBC News, 9:58 a.m.). It is the Commonwealth's reply to McHoul in a sentence, and it is what the defense now has to take apart.
HE CONCEDED THE DIAGNOSIS AND DENIED WHAT THE DEFENSE NEEDS FROM IT. Heilbrun told the jury he found bipolar 2 symptoms on January 24 and that this meant she did have a mental disease or defect. McHoul does not turn on that. It turns on capacity, and on capacity he said she retained an awareness of both the illegality and the moral wrongfulness of the killings (Boston Globe, 9:55 a.m.).
THE ARGUMENT IS ABOUT DECIDING, NOT ABOUT DIAGNOSIS. The prosecution walked him through the killings a step at a time and asked at each step whether that was a decision that had to be made; each time he said it was (NBC News, 9:45 a.m.). Her own account — that she was watching herself, following a voice, deciding nothing — is what that list is built to contradict.
THE CROSS-EXAMINATION RAN FROM JUST BEFORE TEN UNTIL ABOUT HALF PAST TWELVE. Reddington's first lines went to what Heilbrun had not told the jury about the voice, to a bill of about $54,000 for 180 hours which he agreed is not the final figure, and to his first examining the defendant about three years after the day he was asked to reconstruct — an interval he did not defend, agreeing such an examination is better done soon after an offense than late (Boston Globe, 9:58, 10:02, 10:04 and 10:09 a.m.; NBC News, 10:09 a.m.). It then became an attack on his standing to give the opinion at all: his resume read back to him a line at a time, and the concession that in a career of publishing on juveniles, sexual violence and drug courts he has never written an article about postpartum depression or psychosis (Boston Globe, 10:15, 10:18 and 10:20 a.m.; NBC News, 10:24 a.m.). Put to him that he had decided she was “a beast” before he ever met her, he said he did not agree at all (Boston Globe, 10:21 a.m.; NBC News, 10:28 a.m.). Past half past ten it turned to what he knows of her as a mother, and he gave the defense its answers: a very good mother, attentive, in the yard with the two older children hours before they died, and not somebody whose killings he would call a random decision (Boston Globe, 10:27, 10:30 and 10:32 a.m.; East Idaho News, 10:24 a.m.; NBC News, 10:38 a.m.). From about twenty to eleven it was on the year before — a good summer in 2022, the anxiety about going back to work, an October text to her mother saying the medication was making her worse, a December she described as her worst month, and thoughts of harming herself and the children that she told her husband about (Boston Globe, 10:39, 10:40 and 10:46 a.m.). From there it moved to what her providers did with what she was reporting: whether any of them ever asked her where the thoughts came from or whether they were voices, the December night her husband took her to the hospital and she left again without inpatient care, and the postpartum program in Rhode Island that would not take her and recorded anxiety and depression instead (Boston Globe, 10:49, 10:51 and 11:00 a.m.; NBC Boston, 11:02 a.m.). That is the defense's own case put to the Commonwealth's witness, and the recess came with it unfinished. NBC News, alone among the accounts, describes that last stretch as a heated one: Reddington telling the witness he had not read the medical records at all, and an answer he called “word salad” drawing an objection and a direction from the bench to move on (NBC News, 11:08 a.m.). After the break it stayed there: Reddington took him through the December 2022 records from Women and Infants Hospital and had him confirm, line by line, what she had reported to the staff — that she felt like a shell and emotionally flat, that she could feel neither love nor fear, that she thought herself beyond repair, and that she could not get out of bed (Boston Globe, 11:41 and 11:42 a.m.; NBC Boston, 11:54 a.m.). From there it turned on the two things the Commonwealth's account of January 24 rests on. The first is what she said to her husband when he found her in the snow — that she had tried to kill herself and the children were in the basement — which Heilbrun had from Patrick Clancy's testimony and not from any recording; put to him that the 911 tape catches her making only grunting noises, he said he would be surprised, and that he had not listened to it (Boston Globe, 11:46 a.m.; NBC News, 11:58 a.m.). The second is the McLean discharge note from early January 2023, which recorded no psychosis — though he also told the jury the intrusive thoughts returned within a week of her leaving (Boston Globe, 11:51 a.m.). Past noon it arrived at the answer the defense has been working toward since half past nine. Heilbrun agreed that psychotropic medication fails a small number of the people who take it, that her records put her among them, and that he believed she was suffering adverse reactions from October 2022 until January 2023 — the effect, as he put it, “sort of the opposite” of what the drugs were prescribed to do. Whether her providers had treated her properly he said he did not know, that being outside what he was asked to evaluate. Asked then whether the exercising, the cleaning and the online selling of 2022 amounted to a little hypomania, he agreed some of it could be symptoms of mania, and counsel were called to sidebar (Boston Globe, 11:59 a.m., 12:02 and 12:03 p.m.; NBC News, 12:09 p.m.; East Idaho News, 11:59 a.m.). That is the medication theory of the case conceded, in part, by the witness the Commonwealth called to rebut it — though he has not moved from his opinion that she was criminally responsible. After the sidebar the cross turned from the medication to her mind on the day. Heilbrun agreed that psychosis can affect how information is processed and how accurately it is remembered, and the example was her telling him she had cut the window screen when the screen was not cut; her sense of watching herself, he said, is consistent with peritraumatic dissociation (Boston Globe, 12:12 p.m.). Asked to look at the defendant and say whether she had suffered adverse reactions, he said he believed she had, over a prosecution objection to the form of the question that the judge sustained (NBC Boston, 12:18 p.m.). Put to him that following the commands of a voice is a sign of dissociation, he agreed after a contentious exchange, and told the jury she had described intrusive, loud thoughts and a fear that other people could read them — something she said to him, to her husband, and perhaps to others. He added that acute psychosis was one of the explanations he considered when he began (Boston Globe, 12:18 and 12:19 p.m.; East Idaho News, 12:09 p.m.). The last half hour was an argument about the calendar. Reddington's premise is that the six-to-eight-week window Heilbrun used to rule out a postpartum illness is too short, and he set the World Health Organization's year against it; Heilbrun said he did not know the organization's cut-off, that different bodies set different periods, and that the authorities he had relied on — the DSM and the Cleveland Clinic — did not make a postpartum illness the likelier explanation at eight months (East Idaho News, 12:17 p.m.; Boston Globe, 12:23 and 12:28 p.m.; NBC News, 12:34 p.m.). Asked whether those definitions ought to change he would not say, and a one-word retort from Reddington was struck from the record. He then told the jury he believed the defendant was telling him the truth about her own thoughts — that her brain felt damaged to her, and that in January 2023 she had to kill herself — and listed what postpartum depression can look like, agreeing she had reported those things (Boston Globe, 12:29 p.m.). NBC Boston reports the cross-examination ending at about 12:36, its last subject being whether a true command hallucination would put criminal responsibility out of reach; its entry is cut off before the answer (NBC Boston, 12:36 p.m.). The Globe’s own last account of the cross has him on what he had never measured: he has used no instrument for grading the severity of a postpartum depression, and he agreed that delusional beliefs, confusion, sleep deprivation and the sense of not being oneself can all belong to the condition — while refusing the suggestion that the defendant’s insight into her own state was poor (Boston Globe, 12:33 p.m.).
THE REDIRECT IS THE COMMONWEALTH TAKING BACK WHAT THE CROSS TOOK. Jennifer Sprague’s re-examination surfaces in the Boston Globe’s account at 12:33, and its first move was to take the symptoms the defense had spent the last hour listing and say they fit an ordinary depression or bipolar 2 just as well — bipolar 2 being what he diagnosed. From there it was about method rather than conclusion: more records than any case he has worked on, no diagnosis ever asked of him by the prosecutors, no hostility in the interviews, and a deliberate effort not to make up his mind until he had read all of it and seen her. He added that naming a diagnosis publicly early on is the kind of thing that can be associated with confirmation bias — Reddington had named postpartum psychosis soon after he was retained (Boston Globe, 12:33, 12:37 and 12:45 p.m.; NBC Boston, 12:51 p.m.). Then it went at the two things the cross had won. On the voice: the defendant reported unwelcome, intrusive thoughts, but a vivid thought is not a voice and is not by itself psychosis, and what she described at the time of the killings was thoughts rather than auditory hallucinations. On the medication: she had doubted her providers were prescribing the right drugs and said the antipsychotic Seroquel was doing her harm too, but she was taken off it before her discharge from McLean in the first days of January 2023, and Women and Infants Hospital had put down adverse drug effects as possible in her case rather than established (Boston Globe, 12:45 and 12:50 p.m.). The Hearst Connecticut papers have Sprague drawing that hospital's record more finely still — that it recorded a possible adverse reaction and not that the defendant was overmedicated — which Heilbrun accepted without being drawn on where the line between the two lies (CT Insider, 1:05 p.m.). The reply to the long stretch of cross about what her providers never asked her is that she never told them the central thing: Heilbrun said she disclosed thoughts of harming her children to none of them, and that the records have her denying suicidal thoughts but for one point in December 2022 (Boston Globe, 12:50 p.m.; CBS Boston). And the frame around all of it, which is what McHoul actually turns on, is that someone can be in psychosis and still know right from wrong (CBS Boston; East Idaho News, 12:54 p.m.). It closed on the same ground, and more sharply: Heilbrun told the jury that no diagnosis carries the legal test with it automatically — knowing that something is wrong, and being able to hold one's conduct to the law, have to be established on their own — and that someone in a psychotic state can understand the law — and, against the last question of the cross, that a command hallucination does not always leave someone unable to control what they do, many people who hear voices trying to distract themselves into making them stop (Boston Globe, 12:55 p.m.; NBC Boston, 1:06 p.m.; East Idaho News, 12:54 p.m.).
THE RE-CROSS WAS SHORT AND TOOK ONE THING BACK. Reddington had the witness again after the redirect and used him to close off the malingering question: Heilbrun had tested the defendant in April for exaggeration of symptoms, and he agreed she had not lied or malingered in their interviews. Put to him a study finding that auditory hallucinations can come from within a person as well as from outside, he said he was not aware of it. The Hearst Connecticut papers and the Boston Herald both have Reddington putting it to him that he had worked from an earlier report of Dr. Phillip Resnick's when a later one had reached a different conclusion about hallucinations; Heilbrun confirmed he had looked that report up and cited it, and said he did not know of the later one (CT Insider, 1:05 p.m.; Boston Herald, 12:56 p.m.). The last exchange was about the court order Heilbrun had needed before he could visit her, and Reddington's insistence that the jury not be left with the impression his office had blocked that access; it drew an objection and a sidebar, and the jury went to lunch from there (Boston Globe, 1:04 and 1:06 p.m.; NBC News, 1:08 p.m.).
THE POSTURE DISPUTE FROM THIS MORNING IS SETTLED BY EVENTS. The Boston Globe reported the session opening in direct examination and East Idaho News described the judge as saying cross would continue. The Globe's account is the one the day bore out: the Commonwealth questioned Heilbrun until about 9:58 and Reddington began only then.
REDDINGTON SPOKE TO REPORTERS BEFORE COURT. Outside the courthouse on Tuesday morning the defense attorney said the judge had made a "good effort" in instructing the jury to disregard the religious testimony, that he takes the jurors to be conscientious enough to follow it, and that he has "no doubt that we'll finish the case out today" (CBS Boston). This is counsel talking to the press rather than anything said in the courtroom, and the defense making no complaint about the instruction now does not settle what it argues about it later.
MONDAY'S MISTRIAL MOTION WAS DENIED AND DEALT WITH BY INSTRUCTION. Judge Sullivan refused to declare a mistrial over Heilbrun's answer about the defendant's Catholic upbringing, struck the evidence and told the jury it was immaterial, irrelevant and to be disregarded. Whether that instruction was sufficient is the kind of point that survives into an appeal.
STILL UNRESOLVED FROM AUGUST 20: whether involuntary manslaughter goes on the verdict slip and whether the jury is instructed on involuntary intoxication. Both were requested by the defense, opposed by the Commonwealth, and no ruling has been reported.
THE LAST WITNESS IN THE CASE IS ON THE STAND. Judge Sullivan had told the jurors to be back at two for the Commonwealth's last witness without naming him; when court resumed, that witness was Dr. Gregory Saathoff, and the accounts agree he is the last one the Commonwealth means to call. He is a forensic psychiatrist who teaches at the University of Virginia and is the senior psychiatrist for the FBI's Behavioral Analysis Unit at Quantico, and the first half hour of his evidence was spent on that ground: the military before medicine, forty to forty-five turns as an expert witness for prosecutors and defense counsel alike, evaluations of defendants for competency and for criminal responsibility, consulting work in the Virginia prisons, a state hospital before that, thousands of patients seen with psychosis, and five to seven incarcerated women he has treated who killed their own children. After a sidebar the direct examination reached his 1987 paper on postpartum psychosis and bromocriptine — the subject Dr. Heilbrun conceded on cross he has never written about — and then a general account of what psychosis is, which he called a symptom rather than a diagnosis, with many roads to it. He told the jury he takes no payment for the work himself, and that it was the district attorney's office that came to him. The questions then turned to Lindsay Clancy: the records, the video and the expert reports on both sides that he reviewed, about eleven hours of interviews with her over Zoom in May and June, an interview with her husband, and then his analysis, which opened on the voice she says she heard on January 24 while she stood at the refrigerator making the children's dinner. He then began to weigh that account: she had never heard the voice before that night and never heard it after the youngest child died, and he told the jury a voice heard once, speaking without pause and carrying no delusion with it is not typical of psychosis. After a second sidebar he went further. No voice appears anywhere in her records or in what she told the people treating her, he said, and in his experience doing what a command hallucination demands does not make it stop. From there the questioning turned to what she had told him against what others said: that she was at the refrigerator about to make chicken nuggets when the call came, where her husband had the children already eating, and that the voice began after the call, where an account she gave a defense expert put it earlier, when her husband left the house. Those divergent reports, he told the jury, raise questions about what she is telling him and are a cause for significant concern. The questioning then went back over what her husband knew of her medication and what her photographs showed of how she was, and on to her treatment: a mood stabilizer prescribed and filled in December 2022 that she decided against taking for fear of a rash, with no sign in the record, he said, that the psychiatrist who had discussed it with her was told; and McLean Hospital, which she described to him as having left her feeling like a zombie, where the hospital's own assessment of her reads differently. From her treatment he moved to further occasions on which he said her account of herself was not what the record showed — a Christmas at home in 2022, and a friend's visit to her at Spaulding Rehabilitation after the killings — and then to the errands that emptied the house on January 24. She had told him she asked her husband about takeout and looked the restaurant up afterwards; the searching came first, he said, the distance to the restaurant among it, and the pharmacy stop she added as he left was for a medicine the record has her researching nearly an hour earlier. The last of it was her own attempt on her life, which he called serious and said had required a sequence of decisions taken one after another. What that attempt had left out, he said, was that the pills were crushed to a powder before she swallowed them, which he had from her husband and not from her, and which he called quite significant. The direct ended the day on the killings themselves: the order she took the children down in and the parts of the basement she took them to, against how little she told him she could remember of getting them there or of what she said to them. NBC Boston, which named him during the lunch recess, had doubted his evidence could be finished in the afternoon that was left, and it was not — he goes back on the stand on Wednesday morning with the direct still running and the cross-examination still to come. (Boston Globe, 2:14 to 3:52 p.m.; Boston 25, 2:18 to 3:54 p.m.; NBC Boston, 1:22 and 2:19 to 3:56 p.m.; NBC News, 2:21 to 3:54 p.m.; Fox News, 3:18 p.m.; East Idaho News, 2:16 to 3:55 p.m.; Hearst Connecticut, 2:28 to 3:46 p.m.; Patriot Ledger, 2:51 to 3:55 p.m.)
THE BENCH GAVE THE JURY A SHAPE FOR THE REST OF THE TRIAL, AND IT IS A DAY LATER THAN THE ONE THE SITE HAD CARRIED. Judge Sullivan told the jurors as he sent them home that he anticipates the evidence closing on Wednesday, and Boston 25 and East Idaho News both report closing arguments pointed to for Thursday. Until Tuesday afternoon the accounts had pointed to closings on Wednesday; that expectation is superseded by what the judge told the jury, though a Fox News post at 5:35 p.m., writing up counsel leaving the courthouse, still placed the closings on Wednesday. NBC Boston reports that the judge and counsel will have to meet between the close of the evidence and the closings, and ABC News names that meeting: the charge conference, set for Wednesday once the evidence has closed, which is where the two requests still outstanding from August 20 would be decided. The Boston Globe has the judge putting the jury instructions on Thursday as well, after the closings. Where the accounts split is the day the jury actually retires: NBC News reports the judge telling the jurors that deliberations are unlikely to begin before Friday, while the Patriot Ledger has him putting them on Thursday alongside the closings. Both are recorded here and neither is resolved. None of it is a fixed date, and Dr. Saathoff's evidence has already outrun one estimate. Boston 25, 3:54 p.m.; East Idaho News, 3:55 p.m.; NBC Boston, 3:56 p.m.; Boston Globe, 3:57 p.m.; Patriot Ledger, 4:08 p.m.; NBC News, 4:09 p.m.; ABC News, 4:28 p.m.
THE LAST THING THE COMMONWEALTH PUT TO THE JURY ON TUESDAY WAS WHAT THE VOICE DID NOT SAY. Dr. Saathoff told the jurors that the voice the defendant described ordered the children’s deaths but supplied no method, and that everything the method required — three trips down to the basement, a child at a time, against what he called a strong will to survive — was hers. Where she has described herself as a puppet with no control over what she was doing, his answer to the jury was that children are not puppets. NBC News reads the whole line of questioning as aimed at the Commonwealth’s position that she was making one decision after another. NBC News, 4:07 p.m.
COUNSEL ANSWERED FOR HIS CROSS-EXAMINATION ON HIS WAY OUT, AND PUSHED BACK ON THE MEMORY POINT. Leaving the courthouse on Tuesday evening, Kevin Reddington was asked about criticism that he had been rough with a witness and said he gets angry when things are said about his client that have no basis. He called the Commonwealth experts’ treatment of her memory of the voice “ridiculous”, saying nobody in the state she was in could be expected to hold every detail of a day three years behind her. That is contested ground in the evidence rather than a side issue: the inconsistencies Dr. Saathoff put to the jury on Tuesday afternoon — two different accounts of when the voice began, and what she had told other evaluators — turn on exactly it. This is counsel talking to the press and not evidence. Fox News, 5:35 p.m.

On the stand

Witnesses 2

Dr. Gregory Saathoff

Commonwealth

Role: Forensic psychiatrist, the Commonwealth's third and last rebuttal witness
Direct: Commonwealth
Cross: not yet reached
Time: 14:19

Testimony, as reported:

CALLED AFTER THE LUNCH RECESS, AS THE LAST WITNESS IN THE CASE. The Commonwealth called Dr. Gregory Saathoff to the stand when the afternoon session opened, and the accounts agree he is the last witness it means to put on. Boston Globe, 2:14 p.m.; NBC News, 2:21 p.m.; NBC Boston, 2:19 p.m.; Boston 25, 2:18 p.m.
HIS CREDENTIALS WERE THE FIRST THING THE JURY HEARD. The questioning opened on his qualifications: a forensic psychiatrist, a teacher at the University of Virginia — the Hearst Connecticut papers place his chair in emergency medicine — and the senior psychiatrist to the FBI's Behavioral Analysis Unit at Quantico, which the Boston Globe describes as a body that studies criminal behavior. He told the jury he had served in the military before he trained as a psychiatrist. The Globe attributes the FBI and university affiliations to court papers as well as to his own evidence, and East Idaho News records him called as the third of the Commonwealth's rebuttal witnesses. Boston Globe, 2:14, 2:20 and 2:27 p.m.; Boston 25, 2:18 and 2:21 p.m.; NBC Boston, 2:19 p.m.; NBC News, 2:21 p.m.; East Idaho News, 2:16 p.m.; Hearst Connecticut, 2:28 p.m.
HE HAS GIVEN EXPERT EVIDENCE FOR BOTH SIDES, FORTY TO FORTY-FIVE TIMES. He put the number of his appearances as a forensic psychiatrist at forty to forty-five, and told the jury he has been called by prosecutors and by defense counsel alike. His work has included examining defendants for competency to stand trial and for criminal responsibility, which is the question this jury has to answer. Boston Globe, 2:25 p.m.
MUCH OF HIS PRACTICE IS INSIDE PRISONS. He described consulting for the Virginia corrections system, where the task is assessing and treating people who are already incarcerated rather than examining them for a court. Boston Globe, 2:25 and 2:27 p.m.; Hearst Connecticut, 2:28 p.m.
HE HAS TREATED BETWEEN FIVE AND SEVEN WOMEN WHO KILLED THEIR OWN CHILDREN. Asked about that group, he answered “I would say five to seven women who had killed their children”, and said he had both evaluated and treated them, diagnosing them himself and treating them with a team — medication and group therapy, as East Idaho News has it. He told the jury the value of the work lay in their being “able to speak about their experience and also how to deal with issues or how they dealt with issues over and above the medications that they were receiving”. Boston Globe, 2:25 p.m.; NBC News, 2:34 p.m.; Boston 25, 2:25 p.m.; East Idaho News, 2:24 p.m.; Hearst Connecticut, 2:28 p.m.
HE HAS SEEN THOUSANDS OF PATIENTS WITH PSYCHOSIS. That was his answer on how much of the condition at the center of this case he has met in practice, and counsel were called to the bench directly after it. Boston Globe, 2:28 p.m.; Boston 25, 2:30 p.m.
HE HAS PUBLISHED ON POSTPARTUM PSYCHOSIS, WHICH THE WITNESS BEFORE HIM HAD NOT. He told the jury about a paper he co-wrote in 1987, one of five authors, on two women he had seen as an intern whose psychosis followed bromocriptine, a drug then given to stop lactation. The authors concluded the drug had played a part in the illness, and he said the Food and Drug Administration took it off the market in the mid-1990s. The morning's cross-examination had drawn the opposite from Dr. Heilbrun, who agreed he has never written on postpartum illness at all. Boston 25, 2:35 p.m.; Boston Globe, 2:33 and 2:34 p.m.; NBC News, 2:49 p.m.; NBC Boston, 2:42 p.m.
EAST IDAHO NEWS RECORDS THAT HE IS NOT BOARD CERTIFIED. Its note of his credentials ends with that. No other account read for this index mentions his certification either way, and nothing is yet reported about what, if anything, was made of it. East Idaho News, 2:16 p.m.
THE HOSPITAL WORK BEHIND THE PRISON WORK. Picking the direct examination up after the sidebar, he told the jury he had worked at a Virginia state hospital, whose patients were people with severe mental illness who had been committed there. East Idaho News, alone in carrying it, has him putting fifteen years into running an inpatient unit at a teaching hospital. Boston Globe, 2:33 p.m.; East Idaho News, 2:24 p.m.
HE SET OUT FOR THE JURY WHAT PSYCHOSIS IS. Asked to describe the condition at the center of the case, he said it takes more than one form. There are the perceptual disturbances — hearing voices or sounds, and hallucinations that can as easily be seen, felt or smelled — and there are delusions, and there is speech that comes out disconnected or hard to follow. Any one of them will do on its own: “Sometimes you can have psychosis, or someone can be psychotic, with just a delusion and no perceptual disturbance, no type of hallucination,” he said. Boston Globe, 2:37 p.m.; NBC News, 2:49 p.m.; NBC Boston, 2:42 p.m.
PSYCHOSIS IS A SYMPTOM, HE SAID, AND MANY THINGS BRING IT ON. He told the jury psychosis is “a symptom” of something else rather than a diagnosis in its own right, and that “there are many different possible causes” — a serious medical problem such as a brain tumor, what is left behind by drug abuse, schizophrenia, which often carries it, and the mood disorders. “There are many different roads,” he said. Boston Globe, 2:39 p.m.; NBC News, 2:49 p.m.
HE IS THE ONE COMMONWEALTH EXPERT WHO IS NOT BEING PAID. Where the fees of the experts before him were fought over on cross-examination, Saathoff told the jury that what his expert work earns goes to his department at the university, and that his own salary is fixed whatever number of cases he takes on. “I don’t receive payment myself,” he said. “I see it as part of my job as a professor.” He said the district attorney is not paying him for the testimony, that the Plymouth County district attorney's office was the party that approached him about this case, and that the conclusions he reached were his own. The Boston Globe sets the answer against the Commonwealth's earlier experts, who told the jury they were paid substantial sums for their work on the case. Boston Globe, 2:45 p.m.; NBC News, 2:50 p.m.; NBC Boston, 2:50 p.m.; Boston 25, 2:43 p.m.
WHAT HE READ AND WATCHED BEFORE HE FORMED A VIEW. He accounted to the jury for the material behind his work: the defendant's medical records, which he called a “significant body” of material, grand jury material, police reports, video of interviews, video of the Clancy family at a museum, and the reports written by the experts on both sides. He described the sheer quantity of it available in the case as “truly significant”. Asked what falls under serious mental illness, he gave the jury schizophrenia, bipolar disorder and schizoaffective disorder. Boston Globe, 2:48 p.m.
HE EXAMINED THE DEFENDANT HIMSELF, OVER TWO DAYS THIS SPRING, AND HER HUSBAND TOO. He told the jury he interviewed Lindsay Clancy over Zoom on two occasions this spring — Boston 25 gives the dates as May 29 and June 4 and the total as eleven and a half hours, the Boston Globe as about eleven hours across May and June — and that she was pleasant and responsive to his questions on both. He said he could not travel to see her in person at the time, for personal reasons; that he has conducted evaluations by video before; and that an interview in the same room has advantages over one on a screen. He interviewed Patrick Clancy the same way. The Hearst Connecticut papers break the total down into six and a half hours on May 29 and five on June 4, and have him telling the jury that the limits of a video interview did not stop him building a rapport with her. The Boston Herald splits the two sessions as six and a half hours in May and five and a half in June, a total that matches neither of the figures the other accounts give; the difference is left as each outlet reported it. Boston 25, 2:47 and 2:49 p.m.; Boston Globe, 2:48 and 2:54 p.m.; NBC Boston, 2:50 and 2:59 p.m.; Hearst Connecticut, 3:02 p.m.; Boston Herald, 2:46 and 2:48 p.m.
THE DIRECT EXAMINATION REACHED THE VOICE SHE DESCRIBED. Taken to his analysis of the case, he started with the command hallucinations and gave the jury the account she had given him. She was standing at the refrigerator making the children's dinner when a voice she placed outside her own head spoke to her, and on her account it came as soon as a telephone call with her husband ended. The Boston Globe has the voice telling her this was her “last chance” and directing her to kill herself and the children; Boston 25 renders the command as the voice repeating that this was her last chance and that she had to kill the children and then herself. Saathoff told the jury that she had given another provider a fuller version of it, in which the voice added a threat to the children: they would suffer for her refusal. Boston 25, which is furthest ahead, has him saying she told him the voice stopped when Callan Clancy died, and that she then went upstairs to her bedroom. The Hearst Connecticut papers carry the character of the voice as she gave it to him: a man’s, very clear, placed outside her own head, and constant — saying the same thing over and over while she killed the children. The Boston Globe, writing the account up again at 2:58, sets the telephone call in its context, though it attributes that context to other evidence in the case rather than to this witness: she had sent her husband out for their daughter’s medication and for a takeout order, he rang about the medication, and she did not answer at first but called him straight back. Boston Globe, 2:54 and 2:58 p.m.; Boston 25, 2:55 and 2:56 p.m.; NBC Boston, 2:59 p.m.; Hearst Connecticut, 3:02 p.m.
HE TOLD THE JURY THE VOICE SHE DESCRIBED DOES NOT BEHAVE THE WAY VOICES DO. This is the first stretch of his evidence weighing her account rather than setting it out, and he took it apart on four counts. She had never heard the voice before January 24, and had never reported hearing any voice at all across years in which her depression and her anxiety are on the record; that, he said, was unusual. Jennifer Sprague asked him whether it is typical for someone in psychosis to hear a voice once, never before it and never after, and he answered no. It ended, on the account she gave him, at the moment the youngest child died: “Also what was very unusual was the fact that the voice stopped with the death of, or the strangling of her youngest son, Callan. And that she went upstairs and proceeded to engage in behavior in an effort to kill herself but that the voice had stopped as soon as she strangled Callan, her youngest child.” A voice that speaks without pause rather than coming and going is unusual too, he said, and one that arrives with no delusion beside it would be “pretty rare”. Of the description as a whole he told the jury “It’s absolutely not typical.” Asked why he found it so, he pointed the jury back to what she had reported in the months before: her earlier accounts of wanting to kill herself, and the thoughts of harming herself and the children that she had disclosed. Counsel were called to the bench after the answer. Boston Globe, 2:58 and 2:59 p.m.; Boston 25, 2:57 p.m.
AFTER THE SIDEBAR HE WENT BACK OVER THE VOICE SHE DESCRIBED, AND THEN PAST IT. When the questioning picked up again he repeated that hearing a voice once is not typical, and that a voice running without a break rather than coming and going is not typical either; on the account she gave him it kept the same tone and the same words over and over until the children were dead. To hear a voice with no delusion anywhere beside it would be “pretty rare”, he said, and he saw nothing delusional in the way she recounted it to him. Then he went further than he had before the break. She had reported no voice to anyone treating her — Fox News has him listing psychiatrists, nurse practitioners, emergency staff and McLean Hospital — and the hallucination surfaces first in his own evaluation rather than anywhere in her records. And on command hallucinations as he has met them, doing what the voice demands is not what ends it: Boston 25 has him telling the jury the act “is not curative” and that he has never come across a case in which carrying out the command stopped the voice. NBC News sets the answer beside Dr. Heilbrun's, who told this jury much the same thing about a hallucination that came once and lasted a short time. The Patriot Ledger and the Boston Herald carry a proposition the rest of the accounts do not: it is not typical, he said, for someone to act at once on what a voice tells them. Boston Globe, 3:07 p.m.; Boston 25, 3:02 p.m.; NBC News, 3:14 p.m.; Fox News, 3:18 p.m.; NBC Boston, 3:19 p.m.; Hearst Connecticut, 3:18 p.m.; Patriot Ledger, 3:41 p.m.; Boston Herald, 3:04 p.m.
THE FIRST INCONSISTENCY HE PUT TO THE JURY WAS ABOUT CHICKEN NUGGETS. She told him she was at the open refrigerator, about to make the children chicken nuggets, when her husband rang, and that the voice began once the call ended. Patrick Clancy told him the children were already eating: the Boston Globe has Dawson eating chicken nuggets before his father left the house, and Boston 25 has the prosecutor putting it that Patrick last saw the boy with chicken nuggets and green beans in a bowl on the couch, with photographs from the scene showing the same thing. Dr. Saathoff told the jury the difference was a cause for concern in his evaluation. Boston Globe, 3:07, 3:10 and 3:11 p.m.; Boston 25, 3:08 p.m.; Hearst Connecticut, 3:18 p.m.
SHE HAD ALSO GIVEN TWO DIFFERENT TIMES FOR WHEN THE VOICE BEGAN. He told the jury she had been very clear with him about when it started — after the telephone call — and that it ran constantly from there until the children were dead. Elsewhere she had placed it earlier. Boston 25 names the defense expert Dr. Spinelli as the one she told that the voice came when her husband left the house for the pharmacy and the restaurant; the Patriot Ledger has him referring generally to what she said to other experts, and the Boston Globe to a different timeline given to a health care provider. “The two stories don't match,” Boston 25 has him say. “Which version is the one I should consider?” Taking the discrepancies together, he told the jury that “the widely divergent reports … raise questions about what she is telling me and how things are happening”, and that “certainly that's a cause for significant concern”. NBC News has him answering more shortly that it is inconsistent, and describes several such details as red flags to him. The Boston Globe reads the passage as the witness putting it to the jury that she is an unreliable narrator; that is the newspaper's characterization and not a phrase he is reported using. Boston Globe, 3:10 and 3:11 p.m.; Boston 25, 2:59 and 3:10 p.m.; NBC News, 3:21 p.m.; Patriot Ledger, 3:15 p.m.
WHAT SHE LET PEOPLE SEE, AND WHAT SHE SAID SHE FELT. The questioning went back through the years to what her husband knew. She was taking Prozac, Wellbutrin and propranolol in 2013, when the two of them were dating, and Patrick Clancy told him he did not know until late 2022 that she had ever taken anything for anxiety. In the days before the killings, Dr. Saathoff said, she was taking photographs that showed something very different from what she later described feeling inside. The Hearst Connecticut papers have him offering the photographs and the social media of 2022 and early 2023 as examples of a picture of herself that misled the people around her. He also gave the jury her account of late 2022: trouble with anxiety, a doctor friend of her mother-in-law's she was told she could see, a recommendation of the mood stabilizer Lamictal, and a discussion of that drug with Dr. Jennifer Tufts, one of her providers, on December 1, 2022. Boston Globe, 3:15 p.m.; Hearst Connecticut, 3:18 p.m.
ONE OF HER FEARS HE CALLED RATIONAL. Asked about her fear that saying more about her mental health would end with her children being taken away from her, he told the jury that fear was a rational one rather than an irrational one. NBC Boston, 3:19 p.m.
THE LAMICTAL WAS PRESCRIBED AND FILLED, AND SHE DECIDED NOT TO TAKE IT. Dr. Saathoff told the jury the prescription for the mood stabilizer was written and filled, and that she then chose not to take the drug because she was afraid of developing a serious rash. What he could not find in the record, he said, was any sign that Dr. Jennifer Tufts — whom the Boston Globe describes as among the first psychiatrists to treat her after the birth — had been told of that decision: "I don't see evidence that" she was "notified that she had decided against the Lamictal," he said. The questioning went on to McLean Hospital, where, on the account she gave him, she had "felt like a zombie". The hospital's own records do show her doing badly, he said, but their overall assessment of her differs from the way she described it to him. The Patriot Ledger puts the same evidence more flatly, as her having never taken the drug and never told Dr. Tufts so. NBC Boston has him giving the jury his reason for dwelling on a gap of this kind: what a patient is candid about her symptoms is what allows the people treating her to diagnose them and treat them. Boston Globe, 3:20 p.m.; Patriot Ledger, 3:41 p.m.; NBC Boston, 3:45 p.m.
THERE WERE OTHER PLACES, HE TOLD THE JURY, WHERE WHAT SHE SHOWED PEOPLE AND WHAT SHE SAID SHE FELT CAME APART. Dr. Saathoff said she had looked into other treatments for depression as well, esketamine among them. On Christmas of 2022 the two accounts of his evidence describe the meal differently: the Boston Globe has him giving the jury a Christmas morning breakfast with her family at which she was trying to present that she was doing well when she was not, and the Hearst Connecticut papers an occasion on which she helped with a Christmas dinner she did not feel equal to, and let her husband think otherwise rather than say so. The Boston Herald has a third version: she told him she felt she had to be “fake” with her family over Christmas, keeping up an appearance that things were well and that she was equal to helping host, although her family already knew she was struggling. None of the three quotes him at any length on it. He then turned to Spaulding Rehabilitation, where she was treated after the killings. A longtime friend came to see her, and on the account she gave him the visit was gossip and catching up on news; she was upset with the staff for pressing a superficial conversation on her in which she was barred from talking about the killings, and afraid that the visit would leave a false impression of her state of mind. She also told him Spaulding was more concerned with her spinal injury than with her mental health. “It’s inconsistent,” he said of that, pointing to records showing that mental health clinicians had in fact seen her there. Boston Globe, 3:28 p.m.; Hearst Connecticut, 3:46 p.m.; Patriot Ledger, 3:41 p.m.; Boston Herald, 3:24 p.m.
THE TAKEOUT ORDER THAT TOOK HER HUSBAND OUT OF THE HOUSE GOT A LONG PASSAGE OF ITS OWN. Dr. Saathoff said he had asked the defendant about sending Patrick Clancy out for food shortly before the children died. Her account to him, the Boston Globe reports, was that she texted her husband to ask whether he wanted takeout and looked up the Plymouth restaurant, ThreeV, only after he said yes; the Hearst Connecticut papers have her question to him as “how about getting takeout at ThreeV?” Her phone put the searching first, he told the jury — a lot of it before the message, including how far away the restaurant was — and he called that a significant piece of evidence. The family had eaten there, he said, but had never ordered takeout from it, and there were places nearer their house in Duxbury they used more often; Patrick Clancy named several of those to him, while she had told him ThreeV was the only takeout restaurant she could think of. The errand at the pharmacy he treated the same way. She asked her husband as he was leaving to collect medicine for one of the children — Boston 25 names it as Miralax and the Boston Herald says it was for Cora — and the record has her looking that medicine up online nearly an hour before she asked him. Boston 25 has him telling the jury the stop lengthened the trip, gave her husband one more thing to do and meant a longer time he would be away, and sums the passage up as divergences between the account she gave him of the errands and what he found elsewhere. The Boston Globe adds a reading of its own, that the minute detail fed the prosecution's theory of a killing planned and carried out methodically; that is the newspaper's characterization and not a phrase he is reported using. Boston Globe, 3:28, 3:36 and 3:39 p.m.; Boston 25, 3:35 and 3:39 p.m.; Hearst Connecticut, 3:46 p.m.; Boston Herald, 3:30 p.m.
HE TOLD THE JURY WHAT HER OWN SUICIDE ATTEMPT HAD REQUIRED OF HER. Dr. Saathoff said the attempt she made on her own life was a serious one, and that his report set out that it had also called for a sequence of decisions taken one after another. He set it against what was already on her record: two earlier occasions on which she had reached a suicide hotline, an emergency room visit on December 15, 2022, and her own reports of being troubled by thoughts of harming herself and of killing herself. On the account she gave him she fetched a knife, went upstairs and tried to cut herself, and took an overdose of pills — though he told the jury she had not said she took handfuls of them and had not described the overdose in any specific way — and then slashed the screen and dove out of the window. That is the same screen Dr. Heilbrun was asked about in the morning, when he told the jury he did not believe it had been cut. Boston Globe, 3:39 p.m.
THE PART OF THE OVERDOSE SHE LEFT OUT WAS THAT SHE HAD CRUSHED THE PILLS. Dr. Saathoff stayed with the attempt she made on her own life and told the jury what her description of it had omitted. She had told him she went to the couple's bedroom, cut at her wrists and neck, and swallowed pills; the Patriot Ledger has her account of taking the knife from the butcher block in the kitchen and saying nothing further about how the pills went down, and the Boston Globe has him calling her description of the overdose a vague one. The pills had been reduced to a powder first, which he said she never mentioned to him. “She omitted the fact that she had actually crushed the pills,” he told the jury. “I found that to be quite significant.” What he had instead came from her husband, who told him he saw a wine tumbler in the bedroom with crushed medication in it. She had told him — and, he said, had told Dr. Phillip Resnick as well — that the tumbler held lemonade, left there from the night before; Patrick Clancy told him he did not think there was lemonade in the house and did not think his wife drank much of it. NBC News reports the reason he gave it weight: lemonade would cover how bitter the powder was. Grinding tablets that fine without the right equipment he called challenging, “not an easy thing to do … kind of a laborious process”, and he returned to the phrase he had used for the attempt as a whole, that it had taken sequential decision-making. “She omitted some things that I thought were significant,” he said. Boston Globe, 3:43 and 3:45 p.m.; NBC News, 3:54 p.m.; Patriot Ledger, 3:55 p.m.; East Idaho News, 3:30 p.m.
THE DIRECT EXAMINATION REACHED THE KILLINGS THEMSELVES IN ITS LAST MINUTES. Dr. Saathoff gave the jury the account the defendant had given him of what she did after the telephone call with her husband ended. She took Dawson down to his father's basement office and strangled him there, went back up for Cora and strangled her in a different part of the basement, and went up a third time for the baby. Through all of it, on the account she gave him, the voice was repeating its demand that she kill the children. What she could not supply him with was the detail in between. She did not recall what she said to Dawson to get him to come downstairs, and did not recall what she said to Cora; NBC Boston has him telling the jury she did not remember how she got them down the steps at all, and quotes him on asking her where the youngest child had been — “I asked her, ‘Where was Callan, upstairs?’ She said she couldn't really remember.” He had asked her outright how she got Dawson downstairs and whether the boy resisted, and she could not tell him: “She could only recall bringing him down the steps and then strangling him,” the Patriot Ledger has him say. Her husband had told him the bedroom door was locked when he got home; she told him she did not remember locking it. East Idaho News, which also has him saying she could not recall how Cora came downstairs, records him turning to video of the children and observing of them that “they can walk and they can run”. The Hearst Connecticut papers give the demand she described as running through the whole of it, and give its stated purpose: the voice was telling her to kill the children so that she could kill herself. Boston Globe, 3:49 and 3:52 p.m.; Boston 25, 3:50 p.m.; NBC Boston, 3:49 p.m.; East Idaho News, 3:44 p.m.; Patriot Ledger, 4:07 p.m.; Hearst Connecticut, 4:02 p.m.
THE VOICE TOLD HER TO KILL THE CHILDREN AND DID NOT TELL HER HOW, DR. SAATHOFF TOLD THE JURY. He put weight on the gap between the demand the defendant described and everything she had to supply herself in order to carry it out. On her own account the voice ordered the deaths; the method was hers, and it took her down to the basement and back up three times, a child at a time — an act NBC News describes as physically taxing. That the voice said nothing about how, he told the jury, was significant. Against it he set the way she has accounted for her own part in the killings. She had told clinicians that she felt like a puppet and was not in control of what she was doing while she strangled the children, and his answer to that was “children are not puppets”: “You know, just like adults, children have a will to survive — a strong, strong will to survive. I think it’s just part of being human,” he said. “I mean, they … are active. They can walk. They can run.” NBC News, 4:07 p.m.
THE DIRECT EXAMINATION WAS UNFINISHED WHEN THE DAY ENDED. Dr. Saathoff was still the Commonwealth's witness when Judge Sullivan sent the jury home, and he is to be back on the stand on Wednesday morning. Over the afternoon his evidence ran from who he is, through what psychosis is, to the material he reviewed, the account the defendant gave him of January 24, his reasons for calling that account atypical, the divergences he found between what she told him and what the records and her husband told him, and finally her own description of the killings. It has not been reported reaching the question the jury has to answer — whether she could appreciate the wrongfulness of what she did, or conform her conduct to the law — and the defense has not yet had him.

Dr. Kirk Heilbrun

Commonwealth

Role: Forensic psychologist, the Commonwealth's second rebuttal witness
Direct: Sprague
Cross: Reddington
Time: 09:33

Testimony, as reported:

DIRECT RESUMED, AND RAN UNTIL ABOUT TEN TO TEN. Heilbrun went back on the stand at about half past nine to finish the direct examination the mistrial motion cut short on Monday, with Assistant District Attorney Jennifer Sprague putting the questions. East Idaho News's 9:31 entry had the judge telling the jury that cross-examination would continue, which the morning did not bear out; the Boston Globe's account of a resumed direct is the one that matches what followed. Boston Globe, 9:42 a.m.; NBC News, 9:36 a.m.; East Idaho News, 9:31 and 9:33 a.m.
PERITRAUMATIC DISSOCIATION, DEFINED FOR THE JURY. Asked what the term means, Heilbrun described feeling cut off from yourself in the middle of something traumatic — East Idaho News has him putting it as experiencing things as unreal — and he agreed the killings were traumatic for the defendant. He also told the jury the condition can present like psychosis and still not be psychosis. Boston Globe, 9:39 and 9:43 a.m.; East Idaho News, 9:33 a.m.
HER ACCOUNT: NO DECISIONS, ONLY THE VOICE. Heilbrun relayed what the defendant had told him about January 24 — that she felt she was not the one doing it and was watching herself, and that she was doing nothing but obeying the voice, with nothing decided along the way. "She talked about feeling like it wasn't her, like she was watching herself," he testified. Boston Globe, 9:39 a.m.
HIS ANSWER: A RUNNING SEQUENCE OF CHOICES. Against that he set the things he said carrying out the killings required somebody to settle: using the basement, which child went first, what was said to keep them calm, what was used to strangle them, and how she then tried to kill herself. "This is difficult but important to say — that there are many ongoing decisions that have to be made to accomplish a killing like this in 18 to 20 minutes," he said. "For example, why the basement, who among the children goes first, what do you say to the kids to keep them from panicking." Boston Globe, 9:39 and 9:42 a.m.; East Idaho News, 9:33 and 9:37 a.m., which records a defense objection at 9:37 and not how it was resolved. CBS Boston carries the same quotation.
GUARDED WHEN HE ASKED ABOUT HER MENTAL STATE. Heilbrun said that in an interview in April the defendant was cautious and guarded about her mental state at the time of the killings, and much more so than when he asked her about the day before. He said she often answered that she could not remember — one example he gave the jury was which wrist her Apple Watch had been on, another was that she had no memory of writing, once she came round in the hospital, that she felt horrified. Boston Globe, 9:42 and 9:43 a.m. NBC Boston has the change coming across the three interview days rather than within one: on the first day, it reports him saying, she had a good memory for dates, medications and dosages, and it was by the third that she struck him as much more cautious and guarded. NBC Boston, 9:51 a.m.
TWO VERSIONS OF WHAT THE VOICE SAID. Heilbrun told the jury the defendant described the voice to a hospital staff member as telling her to kill herself and saying the children would suffer without her, and that what she later described to him did not match it. He also said she told the staff member she had to kill herself and the children so that they would not suffer. Boston Globe, 9:49 a.m.
A SUICIDE ATTEMPT, AND KILLINGS "OUT OF LOVE". His conclusion, as the Globe reports it, was that the defendant made a serious attempt on her own life and killed the children out of love. Boston Globe, 9:43 a.m. Whether he used the term altruistic filicide from the stand on Monday is logged unresolved in the evidence file and this does not settle it. Fox News, which keeps a day-20 blog of its own, has the reasoning he gave for choosing between two explanations: he had set acute psychosis with command hallucinations against a suicide in which she killed the children rather than leave them behind her, and said that once he had finished his evaluation the evidence pointed much more strongly to the second. Part of her thinking he called realistic — the children would in fact have struggled without their mother — and part of it distorted, in particular a belief that nobody else could look after them well enough. What drove the killings, on that account, was her depression and hopelessness and her wish not to be parted from them, rather than a voice ordering her to act. Fox News, 10:04 a.m.; its stamps are its own posting times and run about ten minutes behind the Globe’s all morning.
CRIMINALLY RESPONSIBLE, IN HIS CLINICAL OPINION. Heilbrun told the jury the defendant is criminally responsible for the killings. "She retained an awareness of the illegality of killing others, including killing her children," he said. "Her moral awareness of the wrongfulness of the killing was influenced by her strong desire to die and if she were dead, not to leave her children behind." CBS Boston, on a page updated at 9:55, which does not timestamp the answer. Fox News carries a further sentence of the same answer, and it is the one that goes to the second half of the legal test rather than the first: that her depression and hopelessness bore on what she did that day, but that she kept control over whether she did it, when, and how. Fox News, 10:10 a.m.
THE PHONE CALL, AND WHY HE THOUGHT IT MATTERED. Heilbrun called it unusual in his experience for a moment like that to be broken into by a telephone call, and told the jury the call is valuable evidence because it fixes a time and supplies an account from the person on the other end. What Patrick Clancy took from it, he said, was that she sounded distracted, as though something else had her attention — which struck her husband as nothing much, because a woman at home with three children always has something else going on. Boston Globe, 9:49 and 9:56 a.m.
A MENTAL DISEASE OR DEFECT, GRANTED. Heilbrun told the jury he found her to be showing bipolar 2 symptoms on January 24, and that this meant she did have a mental disease or defect. He attributed the killings to depression, hopelessness and a wish to end pain he dated to October 2022, and said that through the months before January she appeared to be doing what she could to get well. Boston Globe, 9:55 a.m.
THE LAST QUESTION ON DIRECT WAS THE WHOLE CASE. The prosecution asked him outright whether, under Massachusetts law, she was criminally responsible. "My clinical opinion is that she was criminally responsible on Jan. 24," he answered, and the Commonwealth ended its examination there. NBC News, 9:58 a.m.
HE TOLD THE JURY SHE IS STILL GRIEVING THEM. ABC News, which filed its account of the direct examination late in the morning, has Heilbrun putting his conclusion to the jury in terms: that the defendant retained an awareness of the illegality of killing others, her own children among them, and that while he is not the decision maker here, his clinical opinion is that she was criminally responsible on January 24, 2023. The same account has him telling the jury she is still in mourning for the children and used language like “I have lost everything, and I don’t want to be here” — so that he would not think of her, he said, as someone self-centered or oriented only to herself. ABC News, filed 11:37 a.m., on the direct examination.
CROSS BEGAN ON AN OMISSION. Reddington's opening line of questioning was about what the jury had not been told: the Globe reports Heilbrun agreeing that he had not laid out for them how the defendant's account of the voice to hospital staff differed from the one she later gave him. That sits awkwardly against the Globe's own 9:49 post, in which he told the jury on direct that the two accounts did not match, and no outlet has yet reported the exchange closely enough to say which is meant. He also agreed that a patient coming out of anesthesia after a medical procedure can be delusional. East Idaho News has that opening framed around post-intensive care syndrome, in which someone who has been through surgery can be delusional and say things that make no sense. Boston Globe, 9:58 a.m.; East Idaho News, 9:54 a.m.
WHAT THE OPINION HAS COST THE COMMONWEALTH SO FAR. Asked how much he had been paid, Heilbrun could not give a figure and put it at roughly $54,000 — 180 hours at $300 an hour, billed before he traveled to Plymouth to take the stand. Asked whether that was the whole of it, he said it was not: "It'll be more, yes." Boston Globe, 10:02 and 10:04 a.m.; NBC News, 10:09 a.m.
HE FIRST EXAMINED HER THREE YEARS AFTER THE DAY IN QUESTION. Heilbrun and Dr. Avram Mack saw the defendant over several days in April, for the prosecution, at Tewksbury Hospital, where she is being treated. Pressed on whether an assessment of her mind on January 24 could be accurate at that remove, he did not defend the interval: he agreed an examination like this is better done soon after an offense than long after it. East Idaho News puts the time the two doctors spent with her at roughly ten hours across the three days. Boston Globe, 10:02 and 10:04 a.m.; East Idaho News, 10:18 and 10:21 a.m.
A GROUP IN FLORIDA IN THE EARLY 1980S. Heilbrun said he had once run therapy for women who had killed their own children — four or five of them, and all severely mentally ill. East Idaho News has the answer given to a question about whether he had ever treated a woman in postpartum psychosis, and dates the group to 1982; the Globe describes the group by what the women had done rather than by any diagnosis. Boston Globe, 10:05 a.m.; East Idaho News, 10:01 a.m.
THE CONSULTING WORK, READ BACK TO HIM. Reddington moved on to the places Heilbrun has worked for, going down the list and having him confirm each one. The FBI and the US Bureau of Prisons were among them, along with other agencies and companies. Boston Globe, 10:09 a.m. NBC Boston's account of the same recital adds a supermarket chain to the clients. NBC Boston, 10:19 a.m.
THE REST OF THE RESUME. The recital went on through postings on treating inmates who are mentally ill and on assessing the risk of sexual violence, a run of work with juvenile offenders, and a list of his publications in forensic psychology and juvenile delinquency. He confirmed them as Reddington read them. Boston Globe, 10:15 a.m.
NOTHING IN A LIFETIME OF PUBLISHING ON POSTPARTUM ILLNESS. Reddington turned from the postings to the writing and asked whether any of it was about the condition this case is about. “Is there one article — one — that you wrote about a woman who is pregnant, who is undergoing postpartum depression and God forbid, psychosis,” he asked. “No,” Heilbrun answered. The single paper of his that touches psychosis, Reddington said, was published 49 years ago, when Heilbrun was a research assistant to his father. Heilbrun did agree that his work has run heavily to the young: “There's a fair amount of focus on juveniles over the years,” he said. He also confirmed writing an article on handling difficult cross-examination, which he said was about how best to get the findings of an evaluation across. NBC News reads the sequence as the witness conceding how little of his career has touched postpartum mental health. Boston Globe, 10:18 and 10:20 a.m.; NBC News, 10:24 a.m.; East Idaho News, 10:16 a.m.
HE DENIED DECIDING BEFORE HE MET HER. Heilbrun said he had spoken with the prosecutors before he evaluated the defendant but could not say how many times, and that he had gone through a very large volume of material first, State Police reports among it, over many hours. Reddington put it to him that he had already settled on her as a beast who killed her three children. Heilbrun said he did not agree with that at all, that he knows what confirmation bias is, and that he had done his best to come to the evaluation with an open mind. Boston Globe, 10:21 a.m.; NBC News, 10:28 a.m.
THREE DAYS OF INTERVIEW, AND WHO SHE UNDERSTOOD HIM TO BE. Heilbrun put the first of the April sessions at four and a half hours and each of the two that followed at three; East Idaho News records the second day as three and a half hours of testing rather than three. He said she was offered a break on each day and took one of the two offers. Reddington put it to him that she had known he came from the district attorney's office, and that whatever she said would be used to tell this jury she knew what she was doing when she killed her children. Heilbrun answered that this was not right. Boston Globe, 10:27 a.m.; East Idaho News, 10:21 a.m. NBC Boston, coming to the confirmation-bias exchange later than the Globe does, adds that he could not remember which hotel he had stayed in the night before the first session, only that it was in Tewksbury. NBC Boston, 10:42 a.m.
HE CALLED HER A GOOD MOTHER. Asked what he had done to learn about her as a parent, Heilbrun said he had reviewed every record given to him, that he had not spoken to any of the nurses, and that he had not looked at her work performance reviews. He said he knew she was attentive to the children and really enjoyed them, and that he would describe her as a very good mother; he agreed she had been in the yard playing with the two older children in the hours before they died. He also refused the suggestion that his opinion amounted to her having decided at random to kill them, saying that characterization was not right. East Idaho News, 10:24 a.m., which also has Reddington asking whether anyone besides the two prosecutors had ever said anything bad about her, and an objection to that question sustained; Boston Globe, 10:30 a.m.; CBS Boston, on a page updated at 10:38, which does not timestamp the answer.
CROSS - A CHUCKLE ON THE STAND. The witness let out what NBC News describes as a nervous chuckle, and Reddington asked him whether he found it funny. Heilbrun said he did not — that what he was reacting to was being asked once more whether he agreed with something he had testified to the day before. NBC News, 10:30 a.m. Fox News describes the same moment as a testy one and says what Reddington was asking him to confirm when it came: his own evidence that the defendant is hardworking and highly self-disciplined. On its account Reddington said, “That’s funny?” and Heilbrun answered, “No, it’s not funny — it’s just that you ask me whether I agree with something that I testified to yesterday.” Fox News, 11:50 a.m.
CONTROLLING, OR DISCIPLINED. Reddington asked whether his opinion was that she is a controlling person, and offered as the example the detailed instructions she wrote out for a babysitter on how to prepare the children's food. Heilbrun said it could indicate somebody “working hard and being disciplined and exerting a certain amount of control.” Asked whether that was something to be used against her, and whether he would call her a bad wife or a bad mother, he said it is not necessarily a bad sign for a mother to be anxious about leaving her children. Boston Globe, 10:27 and 10:32 a.m.
RASCAL FLATTS. Still on how little of her the witness knew, Reddington asked him whether he had heard of the country band Rascal Flatts, and Heilbrun did not follow the question and asked him to repeat it. The point of it, as NBC News reads the exchange, was that she sang the band's songs to her daughter Cora every night before putting her to bed. NBC News, 10:38 a.m.
THE CROSS WENT BACK TO THE YEAR BEFORE. Having spent the first three quarters of an hour on the witness himself, Reddington took him back to 2022 and to the defendant before any of it started. Heilbrun agreed she had come through that summer well and that the trouble began months after the third child was born, when she went looking for help: she was, he said, “happy with certain aspects of her life.” He told the jury Patrick Clancy's parents took the children at times and that they were also in preschool, and that Patrick Clancy had described how hard his wife found it to leave them — the example was a dinner out for their fifth wedding anniversary, which they did go to. Heilbrun said she had worried about taking medication while she was breastfeeding and started it once she stopped, and that by September she was anxious about going back to work and was not yet taking it as prescribed. Boston Globe, 10:39 and 10:40 a.m. East Idaho News has the breastfeeding worry put more precisely — she did not want the SSRI in her breast milk — and records that Tufts raised the dose, that she was content with parts of her life through the summer of 2022, and that Reddington put to the witness that the run of diagnoses and drugs she was given was confusing and upsetting. East Idaho News, 10:34 and 10:36 a.m.
A TEXT TO HER MOTHER IN OCTOBER: THE MEDICATION WAS MAKING HER WORSE. Heilbrun read the jury a message the defendant sent her mother in October 2022, asking her to come and stay and telling her the medication was making her worse. He said he had not known that when her mother did come up, she climbed into bed with her. Boston Globe, 10:40 a.m. East Idaho News dates the message October 20 and records more of what it said: that something was wrong, that her insomnia was terrible, that she did not know how to get through the day, that she had taken the medication and it was making things worse, and that it frightened her and she did not want to be alone. On that account the questioning went on to a text she sent her mother-in-law, Sue Clancy, in the middle of November saying she was unwell, and to Sue Clancy referring her on to somebody else, which is how she came to the perinatal nurse practitioner Rebecca Jollotta. East Idaho News, 10:36 a.m.
DECEMBER WAS THE WORST OF IT, AND THE THOUGHTS SHE REPORTED THEN. Heilbrun said the defendant told him the medication felt as though it were damaging her brain, and that by late 2022 she was disoriented and felt cut off from her own body. “December [2022] was probably the worst month for her as she described it,” he said, and it was in that stretch that she reported intrusive thoughts. Reddington came back again and again to whether any of the people treating her had asked her about those thoughts — whether anyone had asked where they came from, whether they were inside her own head, whether they were voices — and Heilbrun's answer each time was that asking is standard practice in treating somebody who reports them. He also told the jury she had said she told her husband she was having thoughts of harming herself and the children, that he asked whether she had a plan, and that she said she did not — “they're just thoughts.” He would not accept Reddington's characterization of the husband's answer to those thoughts as telling her to power through them, and he said the defendant had cooperated with his evaluation. Boston Globe, 10:46 and 10:49 a.m.; NBC Boston, 11:02 a.m. East Idaho News fills in the answers the Globe summarizes. On its account he told the jury that November was worse and that she described feeling like a zombie; that yes, somebody had asked her about hallucinations, and that her usual answer to being asked whether she was hearing voices was no; that where a patient reports dark thoughts the follow-up is to ask her to say more, and that she said the thoughts about harming the children came to her at times. He also said he had spoken to her husband a couple of times, and that one of the things Patrick Clancy had been living with was her wanting to kill herself and possibly the children. East Idaho News, 10:40 a.m. What the questions are for is the defense theory: Heilbrun has told the jury she said she was not hearing voices, and the defense case is that a male voice was giving her commands. Fox News reports the same refusal and has him putting the husband’s response the other way about: what Patrick Clancy did when she told him was ask the follow-up questions a mental health professional would ask, the question about a plan among them, and she answered each time that there was none and that these were only thoughts. Fox News, 10:54 a.m.
THE THOUGHTS WERE HERS, HE SAID, AND THE HOSPITAL SENT HER HOME. Heilbrun told the jury the defendant described the thoughts of harming herself and the children as her own rather than something spoken to her from outside. He said she called December 15, 2022 one of the worst days of her life — things, as she put it to him, were getting more intense and more difficult — and that her husband took her to the hospital that day. The staff there, he said, took up the general anxiety rather than anything postpartum, and she did not stay long enough to get the level of care an inpatient would have had. “She was trying hard to get help,” he said. Boston Globe, 10:51 a.m.
THE POSTPARTUM PROGRAM IN RHODE ISLAND WOULD NOT TAKE HER. Heilbrun said the defendant spent a day at a postpartum program at Women and Infants Hospital in Rhode Island late in December 2022, was not accepted into it, and was given other treatment options instead. The staff there, he said, put her difficulties down to general mental health rather than to anything postpartum. Reddington put it to him that the real reason they would not take her was that she was on too much medication, and had him read the hospital's notes to the jury: generalized anxiety and depression, with “adverse drug affects” and nothing further specified. “The discharge diagnosis was anxiety and depression,” Heilbrun said. Boston Globe, 11:00 a.m.; CBS Boston, whose day-20 page lists why she was not admitted to the Rhode Island program among the subjects of the cross-examination but carries no timestamps. East Idaho News covers the same stretch and diverges on the name: it has the program that turned her down as Brigham's, where every other account of this case has Women and Infants. It also has Reddington putting to the witness that the alternatives she was offered instead failed her, which he did not accept; asking about her stay at McLean, the group activities there and whether coloring was of any use to her; and making something of her being about seven months past Callan's birth by December, though the entry does not say who made that point or what it was meant to show. East Idaho News, 10:47 a.m.
SHARP WORDS BEFORE THE BREAK. The stretch of questioning that ran up to the recess was, in NBC News's account of it, a heated one. Reddington told the witness he had not even read the defendant's medical records, and called one of his answers “word salad” — which drew an objection from the prosecution and a direction from the bench to move on. No other outlet has described the tenor of the exchange. NBC News, 11:08 a.m.
WHAT THE RECORDS SAID SHE FELT, READ BACK TO HIM. The cross picked up after the recess on the December 2022 records from Women and Infants Hospital, with Reddington having the witness confirm what the defendant had told the staff treating her there. Heilbrun said the records show her medicated, depressed and numb to feeling that month. “She said that she felt like a shell,” he told the jury, and “she felt emotionally flat as a pancake.” She reported being unable to feel either love or fear, thought herself “messed up” and “beyond repair,” and was having difficulty getting out of bed. Asked more broadly about the symptoms she was reporting in the months and weeks before the killings, he acknowledged them and said she had felt hollow. NBC Boston, which calls this stretch of the cross-examination a testy one, has Reddington reading two further lines from the same record — that she “can’t feel love” and that “my life is becoming a disaster” — and has Heilbrun putting those statements to her himself when he examined her. Boston Globe, 11:41 and 11:42 a.m.; NBC Boston, 11:54 a.m.
WHAT SHE WANTED WAS SLEEP, AND THE HOSPITAL COULD NOT GET HER CLINICIAN ON THE PHONE. Heilbrun agreed that what the defendant was chasing in December 2022 was sleep, and that insomnia is capable of bringing on psychosis. The diagnoses the Women and Infants staff recorded, he said, were generalized anxiety and depression. Their notes also show them trying to reach one of the clinicians treating her, and no call ever came back. Boston Globe, 11:46 a.m.
WHAT HE KNEW ABOUT THE SNOW CAME FROM THE HUSBAND, AND HE HAD NOT LISTENED TO THE 911 CALL. Heilbrun told the jury that when Patrick Clancy came back to the house and found his then-wife lying outside in the snow, she spoke to him: she had tried to kill herself, and the children were in the basement. Asked how he knew it, he said it came from Patrick Clancy's own testimony earlier in the trial. Reddington's answer to that was the recording of the 911 call. He put it to the witness that the suicide attempt had injured her spine and her throat, and that anyone listening to the tape would hear her make nothing but grunting noises while her husband was with her — would that surprise him? “I would be surprised, yes,” Heilbrun said. He had never listened to the tape. Boston Globe, 11:46 a.m.; NBC News, 11:58 a.m.
MCLEAN SENT HER HOME IN JANUARY WITH “NO PSYCHOSIS” ON THE DISCHARGE NOTE. Heilbrun said the note written when the defendant left McLean Hospital in the first days of January 2023 described her as cooperative and pleasant and recorded no psychosis. Within a week of her going home, he said, the intrusive thoughts were back, and the counseling she had in that period was limited. Boston Globe, 11:51 a.m. East Idaho News covers the same exchange at greater length. On its account he agreed that a doctor would not let a patient walk out of the door unless she was no danger to herself or anyone else, dated the discharge January 5, and had the note recording her as cooperative and pleasant with a good mood and no anxiety, although she had gone on calling her own mood numb. It also has him agreeing that she felt a little hope on leaving and that what came back within the week was suicidal thinking, and that it was bad — where the Globe's account of the same answer has intrusive thoughts. He added, on that account, that she took the medication and did not get better, could not sleep, and felt like a zombie. East Idaho News, 11:45 a.m.
THE COUNSELING WAS LIMITED, AND HE WOULD NOT CALL HER DISCIPLINE AN EVASION. Heilbrun agreed that the counseling the defendant had in that period was limited. Reddington, whom East Idaho News describes as growing agitated at this point, asked whether he was telling the jury she had been avoiding help, when what she was doing was trying to make the feelings go away and be herself again — and what was wrong with that? Heilbrun answered that what he had testified to was that it mattered to her to feel in control and that she believed discipline and hard work would get her there. That, he said, is not a black mark against her. East Idaho News, 11:49 a.m.
WHETHER ASKING YOUR FAMILY IS MEDICAL ADVICE. Reddington read back to the witness a passage from his own findings that had been gone over the day before, and asked whether turning to your family for tips is good medical advice for somebody suffering from psychosis. Heilbrun said the normal inclination is to ask friends and family whether they have anything to suggest. East Idaho News records an objection in this stretch and does not say how it was resolved, and its shorthand has the adverse reactions to her medication raised here as well. East Idaho News, 11:53 a.m.
THE MEDICATION HARMED HER, THE COMMONWEALTH'S WITNESS AGREED. Heilbrun told the jury that psychotropic medication fails a small number of the people who take it: there are side effects and what the field calls adverse reactions, and rather than helping they can make matters worse. Reading her records, he said, had put the defendant among that few. “It appeared to me, from reviewing the records for Ms. Clancy, that she’s one of those few people where the reactions were very, very different, very poor,” he said — not the reactions the drugs had been prescribed to produce. He put the period at October 2022 to January 2023 and said the effect was “sort of the opposite” of what was wanted. Asked whether the people treating her had treated her properly, he said he did not know, because that had been outside the scope of what he was asked to evaluate. It is the concession the defense has been working toward all morning: NBC News reads the stretch as Reddington building the case that she was never given a clear, focused plan of treatment, and describes him resting his hands on the defendant's shoulders as he asked about the conflicting recommendations she was given. The Boston Globe notes why the answer matters — other experts have told this jury that antidepressants can make a bipolar patient's symptoms worse. Boston Globe, 11:59 a.m. and 12:03 p.m.; NBC News, 12:09 p.m.
HYPOMANIA, PUT TO HIM, AND PART OF IT CONCEDED. Reddington took the witness through a stretch of the defendant's behavior after the third child was born — exercising a fair amount, cleaning, the garage cleared out, and an online selling venture the lawyer called a scam and which lost her money — and asked whether that was not a little hypomania. Heilbrun agreed that some of what had just been described to him could be symptoms of mania. Counsel were called to sidebar immediately afterward. East Idaho News, 11:59 a.m.; Boston Globe, 12:02 p.m., which has the exercising dated to after Callan's birth and the same stretch coinciding with the garage and the online sales.
WHAT PSYCHOSIS DOES TO A MEMORY, AND A SCREEN THAT WAS NEVER CUT. The questioning resumed after the sidebar on exercise — of no use to some people with anxiety, Heilbrun said, and “quite useful” to others — and then turned to what the defendant is able to remember. Psychosis, he agreed, can “affect the way information is processed” and “could affect the accuracy of her memory.” The example was the window she went out of. She had told him she cut her wrists and her neck and then used the knife on the screen; the screen in that bedroom was not cut. He also told the jury that her description of watching herself while the killings happened is “consistent with peritraumatic dissociation.” Boston Globe, 12:12 p.m.
HE WAS ASKED TO LOOK AT HER. Reddington crossed the courtroom to stand with the defendant and put the question to the witness over her: look at her, sir — did he believe she had suffered adverse reactions? The prosecution objected to the form of the question and Judge Sullivan sustained it, and Heilbrun gave the substance of an answer anyway: “I believe she was having adverse reactions.” He again would not say whether the medical care she was given was bad. NBC Boston, 12:18 p.m., which has him dating the reactions from October into December, where the Boston Globe's account of the same concession earlier in the hour had them running on to January 2023. The two accounts differ on where the period ends.
THE VOICE, AND WHETHER FOLLOWING IT IS DISSOCIATION. Reddington asked the witness to agree that severe mental illnesses were involved in this case. “Yes, there were,” Heilbrun said — the question, to him, being which ones. The lawyer then put the defense's own account to him: the defendant has said she was following the commands of a voice in her head, and is that not a sign of dissociation? The exchange that followed was a contentious one, and at the end of it the witness agreed that it was. He told the jury she had described her thoughts as intrusive and loud and had worried that other people could pick them up. Boston Globe, 12:18 p.m. East Idaho News, whose clock runs ahead of the others, has the same stretch and more of its temper: the witness giving the DSM's definition of dissociation as an altered mental state, and Reddington demanding to know how he could testify to what she had said when he could not say who she had said it to. East Idaho News, 12:09 p.m.
SHE THOUGHT PEOPLE COULD READ HER THOUGHTS, AND HE HAD ONCE CONSIDERED PSYCHOSIS. Heilbrun said the fear that others could get at what was in her mind was something the defendant reported to him herself. “She said it to me,” he told the jury. “I believe she said it to [her then-husband] Patrick and she may have said it to others as well.” The thoughts were intrusive and, in her word, loud, and that was why she took them to be audible to anyone else. He then gave the defense an answer no Commonwealth witness has given it: that there were “some possible things that made me think” the killings “might have been a psychotic episode,” and that acute psychosis was, at the start of his work, “one of the possible explanations.” Boston Globe, 12:19 p.m.
HOW LONG AFTER A BIRTH POSTPARTUM PSYCHOSIS CAN BEGIN. Reddington put the timing argument to the witness — that his reason for ruling out a postpartum illness is that she was eight months past Callan's birth, and that the six-to-eight-week window he relies on rests on accepted authority in the field. Against it the lawyer set the World Health Organization, which he put as allowing a year. Heilbrun would not take it: asked what the organization's cut-off is, he said he did not know, and that different bodies set different periods and report different outcomes. What he had used instead, he told the jury, were the DSM and the Cleveland Clinic, and at eight months neither of them made a postpartum illness the likelier explanation. East Idaho News, 12:17 p.m.; Boston Globe, 12:23 and 12:28 p.m.; NBC News, 12:34 p.m. The accounts of the DSM figure do not agree: the Globe has him limiting it to four weeks, where NBC News and East Idaho News have him putting it at one or two months. NBC News also has him calling the manual the conservative end of the range.
WHETHER THE MANUALS THEMSELVES SHOULD CHANGE. Pressed on the definitions he had chosen — the Boston Globe has the question as whether they ought to be changed, NBC News as whether the DSM should give postpartum psychosis more room — Heilbrun would not be drawn. It depended, he said, on a number of things, and he was “not in a position to offer an informed opinion” on it. What Reddington said in reply to that was struck from the record. NBC News has the exchange tipping over into open friction from there: when the witness started an answer with “Let me just say…”, Reddington cut across him with “I don’t want to let you do anything.” Boston Globe, 12:23 and 12:28 p.m.; NBC News, 12:38 p.m.
THE 1977 PAPER WAS ABOUT SCHIZOPHRENIA, NOT PSYCHOSIS. Going back to the article Reddington had put to him during the morning's recital of his publications — the one paper of his that was said to touch psychosis, written when he was a research assistant to his father — Heilbrun told the jury it was not a study of psychosis at all but a study of schizophrenia. Boston Globe, 12:29 p.m.
HE TOLD THE JURY HE BELIEVED HER. Heilbrun said that when he interviewed the defendant in April she told him her brain felt damaged to her and that in January 2023 she had to kill herself. Asked whether he thought she was telling him the truth about her own thoughts, he said yes. He also gave the jury a list of what postpartum depression can look like — being unable to laugh, having nothing to look forward to, anxiety that arrives for no reason — and agreed she had reported that anxiety, days she found overwhelming, constant crying, and thoughts of harming herself. Boston Globe, 12:29 p.m.
THE LAST OF THE CROSS, AND A QUESTION ABOUT A TRUE COMMAND HALLUCINATION. The closing stretch went back over the evidence Heilbrun had said counted against psychosis and over his reasons for setting a postpartum explanation aside, and he named the DSM-5 and the Cleveland Clinic again as what he had relied on. Reddington then put it to him that a defendant who had experienced a true command hallucination would not be criminally responsible. NBC Boston is the only account of the exchange and its entry is published cut off in mid-sentence, so the readable part of it stops before the answer. NBC Boston, 12:36 p.m.
WHAT HE HAD NEVER MEASURED. Heilbrun told the jury he has never used any instrument for grading how severe a postpartum depression is. He allowed the condition a good deal: delusional beliefs can belong to it, and so can confusion, sleep deprivation and the sense of not being yourself, and he said the defendant had reported thoughts of harming herself and of harming the children. What he would not allow was that her insight into her own state was poor. Boston Globe, 12:33 p.m.
THE HOSPITAL'S OWN CHECKLIST FOR THE CONDITION, PUT TO HIM ITEM BY ITEM. In the closing stretch of the cross-examination Reddington took the witness through the criteria Massachusetts General Hospital sets out for postpartum depression and for postpartum psychosis, and had him measure the defendant against each of them. Heilbrun answered that she had met every one of the criteria for the depression and most of those for the psychosis, thoughts of killing her children among them. Boston Herald, 12:30 p.m.
THE COMMONWEALTH TOOK THE SAME SYMPTOMS AND PUT THEM SOMEWHERE ELSE. Back with the prosecution, Heilbrun told Jennifer Sprague that the symptoms Reddington had spent the last stretch listing at him sit equally well in an ordinary depression and in bipolar 2 — which is the diagnosis he settled on. Boston Globe, 12:33 p.m.; NBC Boston, 12:51 p.m. Fox News adds the reason he gave for settling where he did: the defendant has carried a bipolar diagnosis of record through three and a half years at Tewksbury State Hospital. Fox News, 12:52 p.m.
NO CASE IN HIS CAREER HAD COME WITH THIS MANY RECORDS. Heilbrun said he had read more material in this case than in any other he has worked on, and that the records are what let him get at her state of mind on the day when the interview itself did not come until three years later. He told the jury the prosecutors never asked him for a particular diagnosis, that nothing in his conversations with the defendant was hostile, and that he had worked hard to hold off forming an opinion until he had both sat with her and read all of it. Boston Globe, 12:37 p.m.; NBC Boston, 12:51 p.m.
HER FEAR OF BEING AWAY FROM THEM, OFFERED BACK AS PART OF THE ANSWER. On redirect Heilbrun said it counted with him that the defendant had been anxious about leaving her children — for an evening out, at the school door, and otherwise. “It all went together in how she thought about her own kids, felt about her own kids,” he testified. Boston Globe, 12:44 p.m.
THE CONFIRMATION-BIAS CHARGE, TURNED BACK ON THE DEFENSE. Heilbrun told the jury that announcing a diagnosis publicly early on is the sort of thing that can be associated with confirmation bias. Reddington had named postpartum psychosis soon after the defendant retained him, and the Commonwealth put that in front of the jury as an answer to the suggestion, made on cross, that Heilbrun had decided the case before he met her. Boston Globe, 12:45 p.m.
A THOUGHT IS NOT A VOICE, AND WHAT SHE DESCRIBED ON THE DAY WAS A THOUGHT. This is the redirect's answer to the whole of the defense case on hallucination. Heilbrun said the defendant reported thoughts that were unwelcome and intrusive, but that a thought, however vivid, is not the same as hearing a voice and is not by itself a sign of psychosis — and that what she described experiencing at the time of the killings was thoughts rather than auditory hallucinations. On the medication he said she had not been sure her providers were prescribing the right drugs for her, and that Seroquel, the antipsychotic, was in her account doing her harm as well — though he told the jury she was taken off it before her discharge from McLean in the first days of January 2023. He did not recall her ever telling him she knew that many women take Zoloft after a birth without trouble. Boston Globe, 12:45 p.m.
HOW HE SATISFIED HIMSELF A THOUGHT WAS NOT A VOICE, AND AN ANSWER THE TWO ACCOUNTS RENDER DIFFERENTLY. The Boston Herald has Jennifer Sprague asking him how he had determined that the intrusive thoughts the defendant began reporting in December 2022 were not hallucinations, and Heilbrun answering that he had put the question to her directly — whether what she experienced reached her as voices from outside her or as thoughts inside her own head. On the Herald's account of what she told him, she set January 24 apart from the rest: “She said except for on Jan 24, what she was experiencing were thoughts.” The Boston Globe, writing up the same minute of the redirect, has the exception the other way about, with Heilbrun telling the jury that what she described experiencing at the time of the killings was thoughts rather than auditory hallucinations. Both are recorded here as they were published. Which way the answer ran on the one day the case turns on is not resolved by anything yet reported. Boston Herald, 12:45 p.m.; Boston Globe, 12:45 p.m.
WHAT SHE NEVER TOLD THE PEOPLE TREATING HER. Asked on redirect whether the defendant had disclosed to any of her medical providers that she was having thoughts of harming her children, Heilbrun said she had not — “That is my recollection” — and that the records also show her denying suicidal thoughts, apart from one point in December 2022 when she reported feeling suicidal. The cross had spent much of the late morning on what her providers failed to ask her; this is the Commonwealth's reply, that on the central thing she did not tell them. Boston Globe, 12:50 p.m.; CBS Boston.
THE HOSPITAL HAD NOT CONFIRMED THE DRUG REACTIONS. Against the concession the defense drew from him before noon, Heilbrun told the jury that Women and Infants Hospital had recorded adverse drug effects as possible in her case but not yet established. Boston Globe, 12:50 p.m.
HE DECLINED A QUESTION HE SAID BELONGED TO MEDICINE. Sprague pressed the difference between a patient being given too much medication and a patient suffering an adverse effect of it. Heilbrun would not take the question, telling her it called for medical expertise and that he is a psychologist. Boston Herald, 12:48 p.m.
PSYCHOSIS ALONE DOES NOT ANSWER THE QUESTION THE JURY HAS. Sprague had him tell the jury that a person can be in psychosis and still know right from wrong, which is the Commonwealth's way of separating the diagnosis it has conceded from the capacity it disputes. East Idaho News has the examination on the same ground at 12:54, on whether a dissociative or a psychotic state necessarily deprives someone of control over what they do. CBS Boston; East Idaho News, 12:54 p.m.
THE PROGRAMS SHE WAS SENT TO, PUT BACK AS EVIDENCE THAT SHE WAS NOT ABANDONED. East Idaho News has the redirect answering the morning's long account of what her care did not do for her: that the hospitals she went to did refer her onward to programs rather than leave her with nothing, that her husband had raised a concern about how much medication she was on, and that she went along with the changes her prescribers made. This is the only account of the exchange and it is a brief one. East Idaho News, 12:46 p.m.
SHE GOT WORSE THROUGH THE FALL AND LOOKED BETTER WHEN McLEAN LET HER GO. Heilbrun told the jury the defendant seemed to get worse and worse through November and December 2022 and appeared somewhat improved by the time McLean discharged her in the first days of January. He said he was aware she had looked up cognitive behavioral therapy on her phone, which was among the things recommended to her, and that so far as he believes she never booked one. Boston Globe, 12:55 p.m.
A VOICE TELLING SOMEONE WHAT TO DO DOES NOT TAKE THE CHOICE AWAY. This is the Commonwealth's answer to the last question of the cross-examination. Heilbrun told the jury that a command hallucination does not always leave a person unable to control what they do, and that many people who hear voices try to distract themselves into making them go away. Someone in psychosis, he said, can in some cases conform their conduct to the law. Boston Globe, 12:55 p.m.; East Idaho News, 12:54 p.m. Fox News has the answer itself: asked in terms whether somebody hearing a command hallucination could conform their conduct to the law, Heilbrun said, “In some cases they can.” Fox News, 1:08 p.m.
THE LAST ANSWER OF THE REDIRECT WAS ABOUT THE LEGAL TEST ITSELF. “There’s no automatic connection between any mental disorder…and the legal standard for knowing that something is wrong or conforming one’s conduct to the law. That’s why we go through this in such detail,” Heilbrun testified, and told the jury it is possible for a person in a psychotic state to understand the law. That is the whole of the Commonwealth's rebuttal position in one answer: the diagnosis is granted and the capacity is disputed, and the second does not follow from the first. NBC Boston, 1:06 p.m.
ON RE-CROSS, THAT SHE HAD NOT FAKED ANY OF IT. Reddington took the witness back after the redirect and had him confirm that he had given the defendant a test in April to see whether she was exaggerating her symptoms. Asked whether she had lied or malingered in their interviews, Heilbrun answered that she had not. Put to him a study finding that auditory hallucinations can, in Reddington's words, come from within a person and from outside them, he said he was not aware of it. Boston Globe, 1:04 p.m.; East Idaho News, 12:54 p.m.
HE HAD NEEDED A COURT ORDER BEFORE HE COULD SEE HER. In the last of the re-cross Reddington had Heilbrun confirm that a court order was required before he could visit the defendant for his evaluation, and then put to him that he was not suggesting to the jury that the defense or its office had interfered with or impeded that access. The prosecution objected and counsel were called to the bench. NBC News, 1:08 p.m.

From the bench

Rulings 1

12:23A REMARK BY DEFENSE COUNSEL WAS STRUCK FROM THE RECORD. After Dr. Heilbrun said he was not in a position to offer an informed opinion on whether the definitions of the postpartum period should change, Reddington answered “Obviously.” The prosecution objected at once and Judge Sullivan ordered the comment struck. Boston Globe, 12:23 and 12:28 p.m.; NBC News, 12:38 p.m.

In sequence

Procedural 28

09:26Court opened for the day. Judge William Sullivan took the bench and called counsel to sidebar before the jurors were brought in. East Idaho News timestamps the opening 9:26 and describes the sidebar as the judge's usual practice; the Boston Globe puts it at 9:28 and has him taking the bench a little before half past nine.
09:31The jury was brought in and told the Commonwealth was not finished. Judge Sullivan said Dr. Heilbrun would go back on the stand and that one more witness would follow him. East Idaho News, which describes the judge as saying cross-examination would continue; the Boston Globe times the jurors' return at 9:31 as well, following the sidebar, and reports the questioning that followed as direct examination. NBC Boston, which carries the same instruction, quotes the judge declining to say more about the shape of the rest of the trial: “beyond that, I'm not going to speculate too much.”
09:58The Commonwealth finished with Dr. Heilbrun and cross-examination began. The prosecution's last question asked him directly whether the defendant was criminally responsible under Massachusetts law; on his answer that she was, it ended its examination, and defense attorney Kevin Reddington took the witness. NBC News, which times the handover at 9:58; the Boston Globe's first post from the cross-examination carries the same stamp.
11:01Judge Sullivan called the morning recess, at about eleven, with Dr. Heilbrun still under cross-examination. Boston Globe, 11:01 a.m.; NBC News and NBC Boston put it at about the same time. East Idaho News, whose stamps run a few minutes ahead of the Globe's all morning, instead posts court resuming after a morning break at 10:56, which no other outlet records and which its own preceding entries do not support.
11:20THE JURY WATCHED THE EXCHANGE CLOSELY, IN A ROOM WITH NO EMPTY SEATS. NBC News, posting while court was in recess, described the courtroom through the morning: every spectator seat taken, the defendant's parents in the gallery again, and the jurors turning between Reddington and the witness as the two of them went back and forth, several with notebooks open and appearing to write. It is the outlet's observation of the room and not anything said in it. NBC News, 11:20 a.m.
11:33A LINE TO GET IN. NBC Boston posted a photograph of the queue outside the courtroom this morning and wrote that coverage of the case has widened, nationally and beyond the country, as it moves toward closing arguments. This is the scene outside the room rather than anything that happened in it. NBC Boston, 11:33 a.m.
11:37THE RECESS ENDED AND THE CROSS-EXAMINATION PICKED UP WHERE IT STOPPED. Judge Sullivan retook the bench at about 11:37 and the jurors were brought back in a few minutes after him, with Dr. Heilbrun still Reddington's witness. NBC News, 11:39 a.m.; NBC Boston, 11:37 a.m.; Boston Globe, 11:37 a.m., which puts the jurors' return at about 11:40.
12:02COUNSEL WERE CALLED TO SIDEBAR WITH THE CROSS-EXAMINATION STILL RUNNING. The sidebar came directly after a run of questions putting it to Dr. Heilbrun that the defendant's exercising, cleaning and online selling in 2022 looked like hypomania. Neither account says what was discussed at the bench or how long it took. Boston Globe, 12:02 p.m.; East Idaho News, 11:59 a.m.
12:33THE COMMONWEALTH BEGAN ITS REDIRECT EXAMINATION. The Boston Globe’s 12:33 post already has Dr. Heilbrun answering the prosecutor, Jennifer Sprague, and its 12:44 post describes the questioning as redirect examination in terms. NBC Boston’s report that the cross had finished came three minutes later. Both figures are the times the outlets posted rather than the moment the handover happened, and no account gives that. Boston Globe, 12:33 and 12:44 p.m.; NBC Boston, 12:36 p.m.
12:36THE CROSS-EXAMINATION OF DR. HEILBRUN ENDED. NBC Boston reported at 12:36 that Reddington had finished, after a cross that had run from just before ten with one recess. Its last subject was whether a defendant who had experienced a true command hallucination could be criminally responsible, and the entry is published cut off before the answer. NBC Boston, 12:36 p.m.
13:04THE REDIRECT ENDED AND REDDINGTON TOOK THE WITNESS BACK FOR RE-CROSS. The Boston Globe's 1:04 p.m. post already has Dr. Heilbrun answering Reddington again; NBC Boston, posting at 1:06, reports Jennifer Sprague finishing her questions and Reddington getting back up. Boston Globe, 1:04 p.m.; NBC Boston, 1:06 p.m.
13:08AN OBJECTION AND A SIDEBAR IN THE LAST MINUTES OF THE RE-CROSS. The objection came on Reddington's question putting it to Dr. Heilbrun that neither he nor his office had interfered with the witness's access to the defendant, and counsel were called to the bench. No account says what was discussed there. NBC News, writing later in the recess, described how it looked from the gallery: the exchange at the bench appeared intense, and Reddington waved his hands more than once during it. NBC News, 1:08 and 1:38 p.m.; Boston Globe, 1:04 p.m.
13:09THE JURY WAS SENT TO LUNCH, WITH ONE WITNESS LEFT IN THE CASE. Judge Sullivan released the jurors at about one o'clock and told them to be back at two, when they would begin hearing from the Commonwealth's last witness. He did not name the witness. Boston Globe, 1:06 p.m.; NBC News, 1:09 p.m.; East Idaho News, 1:08 p.m.
13:22AN OUTLET NAMED THE WITNESS THE BENCH DID NOT. Writing during the lunch recess, NBC Boston reported that the last of the Commonwealth's rebuttal witnesses is Gregory Saathoff, and doubted whether his evidence can be finished in the two hours or so left between the end of lunch and the end of the court day. This is the outlet's reporting and not an announcement from the bench, and he has not been called. It is the first time any account of this trial has stated plainly who the third rebuttal witness is; until now the name has appeared only on a pre-trial list of the experts the district attorney's office retained, which carried four names for three seats. NBC Boston calls him a forensic psychologist, where the Boston Globe's earlier list had him as a forensic psychiatrist. NBC Boston, 1:22 p.m.
14:13COURT CAME BACK FROM LUNCH AND THE JURORS WERE BROUGHT IN. The afternoon session opened a little after two, the hour the judge had given the jury before the recess; the Boston Globe puts the jury back in its seats at about a quarter past. East Idaho News, 2:13 p.m.; NBC Boston, 2:14 p.m.; Boston Globe, 2:14 p.m.; NBC News, 2:15 p.m.
14:19THE COMMONWEALTH CALLED ITS LAST WITNESS. Dr. Gregory Saathoff took the stand as soon as the jury was back, and the questioning began with his qualifications. Four accounts have him called and agree he is the last of the rebuttal witnesses. The description of him as a forensic psychiatrist settles the point NBC Boston's earlier post left open, that outlet having called him a psychologist during the recess. NBC Boston, 2:19 p.m.; NBC News, 2:21 p.m.; Boston Globe, 2:14 p.m.; Boston 25, 2:18 p.m.
14:28COUNSEL WERE CALLED TO SIDEBAR EARLY IN THE DIRECT EXAMINATION. The bench took counsel at the side directly after Dr. Saathoff told the jury he had encountered thousands of patients with psychosis; the Patriot Ledger has Reddington as the one who asked for it. NBC Boston, writing later in the afternoon, reports that the defense had asked for a separate hearing to test the witness's qualifications, and does not say what the judge made of the request. The direct examination continued after the break at the bench. Boston Globe, 2:28 p.m.; Patriot Ledger, 2:51 p.m.; NBC Boston, 3:19 p.m.
14:33THE DIRECT EXAMINATION RESUMED AFTER THE SIDEBAR. When the questioning picked up it turned from Dr. Saathoff's prison and hospital work to his own writing on postpartum psychosis. Boston Globe, 2:33 p.m.
14:50THE DIRECT EXAMINATION TURNED FROM BACKGROUND TO THE CASE. Having taken Dr. Saathoff through his qualifications, through psychosis in general and through the question of what he is being paid, the Commonwealth moved him on to Lindsay Clancy: the material he had read and watched, the interviews he conducted with her and with her husband, and then his analysis, which opened on the auditory hallucinations she has described. NBC Boston, 2:50 and 2:59 p.m.; Boston Globe, 2:48 and 2:54 p.m.
14:59COUNSEL WERE CALLED TO SIDEBAR A SECOND TIME IN THE DIRECT EXAMINATION. The bench took counsel at the side directly after Dr. Saathoff explained why he found the defendant's account of the voice unusual. The Boston Herald reports the break came on a defense objection to his describing other patients he has treated. Boston Globe, 2:59 p.m.; Boston Herald, 2:58 p.m.
15:02THE DIRECT EXAMINATION RESUMED AFTER THE SECOND SIDEBAR. The break at the bench was short. Boston 25 has the prosecutor questioning the witness again by about three o'clock, and the Boston Globe, posting a few minutes after that, describes him picking up the same ground he had been on when counsel were called forward. Boston 25, 3:02 p.m.; Boston Globe, 3:07 p.m.
15:49THE DEFENDANT’S FATHER LOOKED DOWN AS THE ACCOUNT OF HOW THE CHILDREN DIED WAS GIVEN. NBC News, describing the room while Dr. Saathoff took the jury through the three deaths one by one, reported that the defendant’s father sat in the gallery with his head lowered through parts of it, and that the defendant herself hung her head and wiped her eyes. NBC News, 4:07 p.m.
15:52COUNSEL WERE CALLED TO SIDEBAR FOR THE THIRD TIME IN THE AFTERNOON. The bench took counsel at the side at the end of Dr. Saathoff's account of how the children died, and it was the last thing that happened in front of the jury. Boston 25, watching from the gallery, wrote that it could see no emotion in the room and that the jurors within its view looked serious. The Boston Herald reports the break came on a defense objection to his evidence about what he found significant in the way the children were killed, and in a voice that told her to kill them without telling her how. Boston Globe, 3:49 p.m.; Boston 25, 3:52 p.m.; Boston Herald, 3:48 p.m.
15:54THE JURY WAS SENT HOME, AND THE BENCH SET OUT WHAT IT EXPECTS OF THE REST OF THE TRIAL. When the sidebar ended Dr. Saathoff was told to step down and Judge Sullivan released the jurors for the day, telling them he expects one more day of evidence: “It is anticipated that the evidence will close tomorrow,” NBC Boston has him say. Court is to resume at nine on Wednesday with the same witness back on the stand, and Boston 25 and East Idaho News both report closing arguments pointed to for Thursday, with deliberations to follow them. NBC Boston adds that the judge and counsel will have to meet between the close of the evidence and the closings; its entry is published cut off before it says what for. The Boston Globe, which times the dismissal shortly before four, has the judge putting the jury instructions on Thursday as well, after the closing arguments. Boston 25, 3:54 p.m.; NBC Boston, 3:56 p.m.; East Idaho News, 3:55 p.m.; Boston Globe, 3:57 p.m.
15:57THE JUDGE TOLD THE JURORS TO KEEP AN OPEN MIND, AND PUT DELIBERATIONS NO EARLIER THAN FRIDAY. Releasing the jury for the day, Judge Sullivan warned it that it has not yet heard the whole case: “You’ve heard a lot of evidence, but you haven’t heard all of it, right? And like I said before, you haven’t heard the closing arguments of the attorneys. You haven’t heard the law that you’re going to have to apply to this. So you still have to keep an open mind.” NBC News, which has the closings on Thursday, reports him telling the jurors that deliberations are unlikely to begin before Friday. The Patriot Ledger, writing up the same instruction, has the judge putting the start of deliberations on Thursday alongside the closings. The two accounts disagree about when the jury retires, and no other outlet read for this index gives deliberations a day of its own. NBC News, 4:09 p.m.; Patriot Ledger, 4:08 p.m.
16:06A REPORTER SEATED IN THE PRESS ROW LOST HER CREDENTIALS OVER A MOMENT CAUGHT BY THE COURTROOM CAMERA. NBC Boston reported in the afternoon that video was circulating of a woman described as a reporter, sitting in the gallery, smiling and appearing to wink as a camera panned along the press row, and that Vanity Fair, asked about it, told the station it had revoked her credentials for this trial, citing an editorial conflict. The post is published cut off before the spokesperson’s own words. It is press conduct rather than evidence, the outlet places it on an earlier day without saying which, and no account read for this index reports it raised in front of the jury. NBC Boston, 4:06 p.m. The Boston Globe, writing it up on Wednesday morning, describes her as a freelance reporter covering the trial for the magazine and attributes the revocation to a spokesperson for it. Boston Globe, 8:49 a.m. Wednesday.
16:28THE MEETING BETWEEN THE CLOSE OF THE EVIDENCE AND THE CLOSING ARGUMENTS IS THE CHARGE CONFERENCE. ABC News, writing up the end of the sitting, reports it set for Wednesday once the evidence has closed. That is where the two defense requests still outstanding from August 20 — involuntary manslaughter on the verdict slip, and an instruction on involuntary intoxication — would be decided. NBC Boston had reported earlier in the afternoon that the judge and counsel would have to meet between the evidence and the closings, but its entry was published cut off before it said what the meeting was for. ABC News, 4:28 p.m.
17:35REDDINGTON DEFENDED HIS OWN CROSS-EXAMINATION ON THE WAY OUT OF THE COURTHOUSE. Asked on Tuesday evening about criticism that he had been rough with a witness, the defense attorney put his anger down to what is being said about his client: “The guy’s saying bad things about Lindsay, none of which have a basis. So, yeah, I get a little angry.” He also called the Commonwealth experts’ treatment of her memory of the voice “ridiculous”, saying nobody in the state she was in could be expected to hold every detail of a day three years behind her. This is counsel talking to the press rather than anything said in the courtroom, and the jury has heard none of it. Fox News, 5:35 p.m.

In evidence

Exhibits 0

The archive records no exhibits for this day.

As reported

Account

Dr. Kirk Heilbrun finished the direct examination the mistrial motion had cut short, and the Commonwealth used it to attack the premise that the defendant decided nothing on January 24. He defined peritraumatic dissociation, said it can look like psychosis without being psychosis, and agreed item by item that the killings required choices — the basement, the order, what was said to the children, what was used. He also gave the jury the Commonwealth’s own answer to why she did it, telling them he had weighed acute psychosis with command hallucinations against a suicide in which she took the children with her rather than leave them behind, and that the evidence came down much more strongly on the second. He granted that she had a mental disease or defect, bipolar 2, and then withheld what the defense needs from it, telling the jury she kept her awareness of both the illegality and the wrongfulness of what she was doing and is criminally responsible. The Commonwealth rested its questioning on that answer and Kevin Reddington began cross-examination shortly before ten. For three quarters of an hour it stayed on the witness rather than the opinion: what he had been paid, which he agreed will grow; his resume, read back to him a line at a time; the fact that in a long career of publishing he has never once written about postpartum illness; and the suggestion, which he rejected, that he had made up his mind before he ever met her. Past half past ten it turned to what he knows of her as a mother, and he called her a very good one, attentive, in the yard with two of the children hours before they died. From about twenty to eleven Reddington walked him back through 2022 — a good summer, the anxiety about returning to work, an October text to her mother saying the medication was making her worse, a December she called her worst month, and the thoughts of harming herself and the children she told her husband about — and then through what the people treating her did with all of it: whether anyone ever asked her what the thoughts were or where they came from, the December night her husband took her to the hospital and she was sent home without inpatient care, and the postpartum program in Rhode Island that would not take her and put her difficulties down to anxiety and depression instead. The defense is putting its own case to the Commonwealth's witness, and so far he has confirmed most of it. By the time the judge called the morning recess at about eleven, with the cross-examination still running, it had turned sharp enough for the prosecution to object and for the bench to tell Reddington to move on. Court came back at about twenty to twelve and the questioning stayed where it had stopped, on the December records from the Rhode Island hospital, with Reddington reading back to him what she had told the staff there about feeling numb, hollow and beyond repair. He agreed there that she had been chasing sleep and that insomnia can bring on psychosis, and confirmed that the hospital had tried and failed to reach one of the clinicians treating her. Reddington then went at the account of what she said in the snow: everything Heilbrun knew of it came from her husband's own testimony, and put to him that the 911 tape catches her making nothing but grunting noises, he said he would be surprised — and that he had never listened to it. The last of it before noon was the discharge note from McLean in early January, which recorded no psychosis, and his evidence that the intrusive thoughts came back within a week of her going home. Past noon the cross found the concession the defense most wants from this witness: that the drugs she was given did her harm. Heilbrun told the jury she is one of the few people in whom psychotropic medication produces adverse reactions rather than relief, that he believed she was having them from October 2022 until January 2023, and that whether the people treating her did it properly was not something he had been asked to look into. He agreed too that the exercising, the cleaning and the online selling Reddington put to him could be symptoms of mania, and counsel were called to sidebar. After the sidebar the questioning moved off the medication and onto her mind on January 24. Heilbrun agreed that psychosis can distort how information is taken in and how accurately it is remembered — she had told him she cut the bedroom window screen, and it was not cut — and that her account of watching herself while it happened fits peritraumatic dissociation. He told the jury she had feared other people could read the intrusive, loud thoughts in her head, and that when he began work on the case acute psychosis was one of the explanations he considered. The last half hour of the cross was spent on the calendar. Reddington set the World Health Organization's year against the six-to-eight-week window Heilbrun had used to rule a postpartum illness out; the witness said he did not know what the organization's cut-off is, that different bodies set different periods, and that the DSM and the Cleveland Clinic, which he did rely on, made a postpartum explanation no more likely at eight months than any other. Asked whether those definitions should change he declined to say, and Reddington's one-word answer to that was struck from the record. He then told the jury he believed her about her own thoughts — her brain felt damaged to her, and in January 2023 she had to kill herself — and agreed she had reported much of what postpartum depression looks like. The last of the cross was on what he had never measured — he has used no instrument for grading a postpartum depression — and on how much of the condition he would allow without allowing that she lacked insight into her own state. NBC Boston reports the cross-examination ending at about 12:36. The Commonwealth then had the witness back, and Jennifer Sprague spent the redirect on how the opinion was made rather than on what it says: the same symptoms fit an ordinary depression or bipolar 2, the records were the largest set he has read in any case of his career, no diagnosis was ever asked of him, and he held off deciding until he had read all of it and sat with her. The one part of January 24 he was taken back to was the anxiety she felt about being away from her children. The redirect then went at what the cross had won. Heilbrun told the jury that the thoughts the defendant described were thoughts and not voices, that a vivid thought is not by itself psychosis, and that what she reported experiencing at the time of the killings was thoughts rather than auditory hallucinations; that she had been taken off the antipsychotic she said was doing her harm before she was discharged from McLean; and that the hospital in Rhode Island had written down adverse drug effects as possible rather than confirmed. To the morning's long account of what her providers never asked her, the Commonwealth's answer was that she never told them she was having thoughts of harming her children, and that the records otherwise have her denying suicidal thoughts. Sprague also had him say plainly that a person can be in psychosis and still know right from wrong, which is the distinction the whole rebuttal rests on. The redirect closed on the legal test rather than on the diagnosis: Heilbrun told the jury there is no automatic connection between a mental disorder and the standard for knowing that something is wrong or conforming one's conduct to law, and that a person in a psychotic state can still understand it. Reddington then took the witness back briefly, and got him to say that the test he ran in April showed the defendant had not exaggerated her symptoms and that she had not lied or malingered in their interviews. The last of it turned on the court order Heilbrun had needed before he could see her, and on Reddington putting it to him that the defense had not been what kept him out; the prosecution objected and counsel were called to the bench. Judge Sullivan sent the jurors to lunch at about one o'clock and told them to return at two for the Commonwealth's last witness, whom he did not name. NBC Boston, writing in the recess, reports that witness to be Gregory Saathoff. Court came back a little after two, and the Commonwealth called Saathoff as soon as the jury was back. He is a forensic psychiatrist who teaches at the University of Virginia and is the senior psychiatrist to the FBI's Behavioral Analysis Unit at Quantico, and the first half hour of his evidence was his qualifications: the military before medicine, forty to forty-five turns as an expert witness for prosecutors and defense counsel alike, evaluations of defendants both for competency and for criminal responsibility, consulting work in the Virginia prisons, and between five and seven incarcerated women he has treated who killed their own children. He told the jury he has encountered thousands of people with psychosis, and counsel were called to sidebar. After a sidebar the direct examination moved on to a Virginia state hospital he had worked in and then to his own writing: a paper he co-wrote in 1987, on two women he saw as an intern whose psychosis followed a drug then prescribed to stop lactation, which the Food and Drug Administration took off the market in the mid-1990s. That is the subject the morning's cross-examination had established Dr. Heilbrun has never written about. He then set out for the jury what psychosis is — hallucinations of any of the senses, delusions, speech that comes out disconnected, any one of them enough on its own — and told them it is a symptom of something else rather than a diagnosis, with many different roads to it, from a brain tumor to the aftermath of drug abuse to schizophrenia and the mood disorders. Unlike the experts who came before him he is not being paid: the fees go to his university department, and he told the jury he sees the work as part of his job as a professor. The questions then turned to this case. He accounted for what he had read and watched — the medical records, the grand jury material, the police reports, video of interviews, video of the family at a museum, the reports of the experts on both sides — and told the jury he had interviewed the defendant over Zoom for about eleven hours across two days in May and June, and her husband the same way. By the middle of the afternoon the direct examination had reached his analysis of the case, beginning with the voice she says she heard on January 24: standing at the refrigerator making the children's dinner, as soon as a call from her husband ended, told that this was her last chance. She had never heard it before that night, he said, and it left her at the moment the youngest child died. From there he began to weigh the account rather than relay it. Asked whether a voice heard once and never again is typical of psychosis he told the jury it is not, and said the same of a voice that speaks without pause and of one that comes with no delusion beside it; of the description as a whole he said it is absolutely not typical, and pointed the jury back to the thoughts of harming herself and the children that she had reported to others months earlier. Counsel were taken to the bench, and when the questioning resumed he went over that ground again and then past it: no voice appears in her records or in anything she told the people treating her, he said, and in his experience carrying out what a command hallucination demands is not what makes it stop. He then set what she had told him against what others had. She placed herself at the open refrigerator, about to make the children chicken nuggets, when her husband rang; her husband told him the children were already eating. She was clear with him that the voice began once the call ended; in an account she gave a defense expert she had put it earlier, when her husband left the house on the errands. Neither difference is large on its own, and he did not treat them that way — the widely divergent reports, he said, raise questions about what she is telling him and are certainly a cause for significant concern. The last of the afternoon's reported questioning went back through the years to what her husband knew: the medications she was taking in 2013 when the two of them were dating, which he said Patrick Clancy did not learn of until late 2022, and the photographs she was taking in the days before the killings, which showed something very different from what she later said she felt. From there the questioning stayed with her treatment: the mood stabilizer she was prescribed in December, which he said she filled and then decided against for fear of a rash without, so far as he could see, telling the psychiatrist who had discussed it with her; and her stay at McLean, which she described to him as having left her feeling like a zombie, where the hospital's own assessment of her reads differently. From the treatment record the questioning went on to a run of other occasions on which he said what she showed people diverged from what she said she felt: a Christmas at home in 2022, which the accounts of his evidence describe differently, and the visit an old friend paid her at Spaulding Rehabilitation after the killings, which she described to him as small talk she was upset at being held to and afraid would leave a false impression of her. The longest passage of the late afternoon was the takeout order that took her husband out of the house. She told him she had asked whether he wanted takeout and looked the Plymouth restaurant up only after he said yes; her phone, he said, had her searching first, the distance to the restaurant among it, and he called that significant. The family had eaten there but had never ordered takeout from it, and there were places nearer home they used more often. The errand at the pharmacy went the same way: she asked her husband to collect a child's medicine as he was leaving, and the record has her looking that medicine up nearly an hour before she asked, which he said lengthened the trip and kept him away longer. The last of the reported questioning was on her own attempt on her life, which he called serious and said had required a sequence of decisions taken one after another, and on the account she gave him of the knife, the pills and the window. What that account had left out, he told the jury, was that the pills had been crushed to a powder and stirred into a drink, a laborious thing to do that he had from her husband rather than from her. The last of the direct before the jury went home was her account of the killings themselves — the order she took the children down in, the office and the two parts of the basement, and how little of the rest of it she told him she could remember. Counsel were called to the bench at the end of it, and Judge Sullivan sent the jurors home with Dr. Saathoff still under direct examination and due back on Wednesday morning. He has not been reported giving the jury an opinion on criminal responsibility, and the defense has not yet cross-examined him. The bench told the jury it expects the evidence to close on Wednesday, with closing arguments pointed to for Thursday; NBC News has the judge telling the jurors that deliberations are unlikely to begin before Friday, and cautioning them until then to keep an open mind, while the Patriot Ledger has him putting the start of deliberations on Thursday. The two accounts disagree and both are recorded.

Index terms

Topics 61

Commonwealth rebuttal
peritraumatic dissociation
criminal responsibility
bipolar 2
altruistic filicide
cross-examination
expert fees
expert qualifications
confirmation bias
struck testimony
Commonwealth may rest
closing arguments expected
verdict slip unresolved
medication history
intrusive thoughts
prescribers
hospitalizations
postpartum treatment programs
adverse drug reactions
hypomania
dissociation
thought broadcasting
postpartum psychosis onset
memory reliability
command hallucination
expert authorities
redirect examination
auditory hallucinations
Seroquel
provider disclosure
re-cross examination
malingering
final rebuttal witness
FBI Behavioral Analysis Unit
correctional psychiatry
postpartum psychosis publications
bromocriptine
defining psychosis
lactation-suppressing medication
command auditory hallucinations
materials reviewed
video interviews
expert independence
atypical psychosis
inconsistent accounts
Lamictal
social media portrayal
crime scene photographs
treatment adherence
McLean Hospital records
Spaulding Rehabilitation
candor with clinicians
takeout order
phone search records
suicide attempt
crushed medication
omitted details
order of the killings
trial schedule
deliberations date disputed
charge conference

Reporting relied on

Sources 18

Sources: globe-day-19, nbc-day-19, cbs-day-19, wbur-day-20-preview, cbs-day-20, globe-day-20, ein-day-20, boston-day-20, nbcnews-day-20, nbcboston-day-20, boston25-day-20, boston25-day-20-live, abc-day-20, fox-day-20, ledger-day-20, ctinsider-day-20, herald-day-20, ap-day-20

Identifiers are the archive's own source keys; each links to the report it names where the archive gives a web address.

Mirror of the public trial reference at clancytrial.org, reproduced with its cautions intact. Nothing here is a conclusion about guilt or responsibility; the defendant is presumed innocent. Corrections: [email protected].