August 26, 2026

Dr. Gregory Saathoff

Commonwealth

Role

Forensic psychiatrist, the Commonwealth's third and last rebuttal witness

Direct

Commonwealth, resuming

Cross

Defense, Kevin Reddington, concluded; the Commonwealth redirected through Jennifer Sprague

Testimony, as reported:

• HE WENT BACK ON THE STAND FOR THE PROSECUTION TO FINISH ITS QUESTIONING. Dr. Saathoff was recalled Wednesday morning with his direct examination unfinished from Tuesday. What is already on the record is set out under day 20: his qualifications and his work for the FBI's Behavioral Analysis Unit, about eleven hours of video interviews with the defendant in May and June, an interview with her husband, his evidence that the voice she described does not behave the way voices do, and a series of divergences he said he found between her account and the records. NBC News, 9:18 a.m.; NBC Boston, 9:22 a.m.
• THE RESUMED DIRECT WENT STRAIGHT BACK TO THE VOICE, AND TO WHAT IT DID NOT SAY. On his account of what she told him, the voice named no method. It did not tell her how to kill the children, or where, or in what order, and it gave her no instruction about how she was to kill herself. NBC News, 9:27 a.m.; Boston Globe, 9:21 a.m.
• FROM THOSE SILENCES HE DREW THE CONCLUSION THE REBUTTAL NEEDS. Everything the voice left unspecified was, on his evidence, something she settled herself, which made the order of that night hers rather than the voice's. “It indicated that she had control ... of the sequence of what she was doing throughout,” he said. He also told the jury he found it surprising that she carried all of it out with no further direction or plan of any kind. Boston 25 gives the answer itself: “Having no instructions as to how to do it, but being able to execute those decisions … that is surprising that she’s able to accomplish all of this without any other kind of direction or plan.” Boston Globe, 9:21 a.m.; NBC News, 9:27 a.m.; Boston 25, filed 12:55 p.m.
• AMONG THE DECISIONS HE ATTRIBUTED TO HER WAS CARRYING THE CHILDREN DOWN TO THE BASEMENT ONE AT A TIME. NBC News reports him treating that, inside the stretch of time the defense calls psychosis, as a choice of hers. The Boston Globe records two further points he put to the jury: that she had a short period at home while her husband was out running errands, and that she took a call from him while the killings were under way. On the Globe's account he tied the shortness of that window to the manner of what she did, saying it was “important to do this quickly, methodically and the like.” NBC News, 9:27 a.m.; Boston Globe, 9:21 and 9:31 a.m.
• HE ALSO TOOK THE JURY THROUGH WHAT THE MEDICAL RECORDS SHOW ABOUT HER DECLINE. The records, he said, describe her feeling isolated as her mental health worsened, and not well enough to go back to work; she told him she was under financial strain because she could not work and contribute to the family. Of the attempt she made on her own life he said it was “very, very serious, which is why she employed three different methods,” a reference to the cuts to her wrists and neck and to her going out of the second-floor bedroom window. Boston Globe, 9:27 a.m.
• ATIVAN SETTLED THE INTRUSIVE THOUGHTS, WHICH HE TOLD THE JURY POINTED INWARD RATHER THAN OUT. She had reported intrusive thoughts to him and told him that taking Ativan sometimes ended them — “taking the Ativan resolved those thoughts,” as he put her account. A drug of that kind does nothing to a hallucinated voice, he said, so a thought that Ativan could switch off was to his mind a thought of her own rather than something spoken to her from outside. Boston Globe, 9:33 a.m.
• HE GAVE THE JURY THE DIAGNOSIS, AND IT ALLOWS THE ILLNESS. She was suffering from a mental disease or defect at the time of the killings, he said, and of the diagnoses available bipolar 2 “seemed to make the most sense,” chiefly because of her insomnia. That puts him where the two rebuttal experts before him ended up: the illness conceded, the incapacity denied. Boston Globe, 9:33 a.m.; CT Insider, 9:40 a.m.
• A COMMAND HALLUCINATION, ON HIS EVIDENCE, DOES NOT CARRY THE PERSON WHO HEARS IT ALONG WITH IT. Voices of that kind do not “propel” someone into obeying them, he told the jury. People who hear them commonly push back against what they are told to do, and a person in that state can still keep their conduct inside the law. NBC News records the illustration he offered: told by a voice to do something unlawful with a police officer standing in front of them, a person can decline — “it’s possible for a person to choose not to engage in that behavior.” Boston Globe, 9:33 and 9:38 a.m.; NBC News, 9:38 a.m.
• A COMMAND HALLUCINATION DOES NOT TAKE AWAY THE KNOWLEDGE THAT THE ACT IS WRONG. Even granting that she was hearing commands, he said, she could still have known right from wrong; many people who hear voices act to avoid doing what a voice tells them when it cuts against what they believe. That answer goes to the first half of the test the jury has to apply, as his evidence about the sequence of the night went to the second. Boston Globe, 9:38 a.m.
• HE DREW A LINE BETWEEN TOO MUCH MEDICINE AND A BAD REACTION TO IT. Being overmedicated and reacting badly to a drug are not the same thing, he told the jury. The insomnia that came with Zoloft he put in the second category, an adverse effect rather than a sign of too much, and he noted that Dr. Jennifer Tufts, among the first clinicians she saw after her third child was born, took her off the drug. He agreed she had significant side effects from her medications. Boston Globe, 9:37 a.m.; CT Insider, 9:40 a.m.
• HE FOUND NOTHING IN THE RECORDS TO SAY SHE HAD BEEN OVERMEDICATED. It can happen, he said — a prescriber can set a dose too high — but he saw no sign of it in her medical records. Her prescribers, on his reading, were answering the symptoms she was telling them about. He pointed the jury to December 2022, when she elected to stay on the combination of Seroquel and Valium she was taking: “that combination at that time, that was really helping her sleep,” he said. Boston Globe, 9:42 a.m.
• THE AMITRIPTYLINE DOSE, ON HIS EVIDENCE, WAS A SMALL ONE. Asked about the amitriptyline she was taking, he told the jury that 10 to 20 milligrams is a very low amount for an adult, and agreed that a dose that size is one a child could safely be given. The drug is among those the defense says pushed her over the edge. NBC News, 9:53 a.m.
• HE THEN GAVE THE OPINION THE REBUTTAL HAS BEEN BUILT TOWARD: SHE COULD TELL RIGHT FROM WRONG. Turning from voices in general to this defendant, Dr. Saathoff told the jury she “did have the capacity to appreciate right and wrong” at the time of the killings. That is an answer to the first half of the test the jury has to apply, and it is the same answer Dr. Avram Mack and Dr. Kirk Heilbrun gave before him. Boston Globe, 9:47 a.m.; NBC Boston, 9:49 a.m.; NBC News, 9:54 a.m.; CT Insider, 9:54 a.m.
• WHAT HE BUILT THAT ON WAS PLANNING, WHICH HE CALLED SIGNIFICANT. Before she texted her husband about picking up takeout, he said, she had looked up the distance from the Duxbury house to the restaurant in Plymouth and searched for a CVS. She sent him out on the errand minutes before the killings, and she acted in the window when she was alone in the house — a time, on his evidence, when she knew nobody would see it or interrupt it. The exercise bands she used were near at hand where she was. Taken together, he told the jury, the searches, the timing and the choice of what was within reach showed she understood what she was doing. CT Insider records him adding that she had told him she mapped out the time “because she didn’t want to be alone too long.” Boston Globe, 9:47 a.m.; NBC News, 9:54 a.m.; CT Insider, 9:54 a.m.
• HE POINTED THE JURY TO THE BASEMENT AND THE CLOSED DOOR. The children were strangled in the basement with the office door shut, he said, which to his mind added a level of concealment to what was done. Boston Globe, 9:47 a.m.
• THE APPOINTMENT THE DAY BEFORE THE KILLINGS WENT IN FRONT OF THE JURY. She had seen Dr. Jennifer Tufts, the psychiatrist who had treated her for several months, on the day before the killings. On his account she denied any thoughts of harming herself or anyone else at that appointment, and the two of them discussed what treatment might come next. Boston Globe, 9:47 a.m.
• HE PUT THE REST OF JANUARY 24 IN FRONT OF THE JURY AS AN ORDINARY DAY. She drove to the pediatrician’s office and back, he said — the Boston Globe records the appointment as her daughter Cora’s — played outside with the children and built a snowman with them, and made their lunch and their dinner. “The activities of that day were controlled,” he told the jury. “Throughout the day she was methodical and quite controlled and organized. ... There was a lot to do in terms of killing her children but also killing herself.” Boston Globe, 9:55 and 9:58 a.m.; CT Insider, 10:04 a.m.
• THE CALL SHE TOOK WHILE THE KILLINGS WERE UNDER WAY IS THE DETAIL HE LEANED ON HARDEST. Her husband rang from the CVS and she did not pick up, then rang him back. That, on Dr. Saathoff’s evidence, took presence of mind, and what she did with it was hide what was happening: she told him nothing about being in distress, and returning the call “helped guarantee that he would continue” with the errand instead of turning for home. She “had the presence of mind to do that but also to conceal from him what was going on,” he said. Boston Globe, 9:51 and 9:55 a.m.; NBC Boston, 9:57 a.m.; CT Insider, 10:04 a.m.
• HE TOLD THE JURY WHAT SHE SAID WHEN HER HUSBAND FOUND HER OUTSIDE THE HOUSE. She told him she had tried to kill herself. She did not tell him she had killed the children, and she said nothing to him then about a voice. Boston Globe, 9:51 a.m.
• HE FOUND NO DELUSION ABOUT THE CHILDREN THEMSELVES. There was no evidence, he said, that she held any delusional belief about them. The exercise bands she used were “readily available” where she was, which he called significant to his mind “in terms of her understanding and planning.” Boston Globe, 9:51 a.m.; CT Insider, 9:54 a.m.
• HE GAVE THE JURY THE ANSWER TO THE QUESTION IT HAS TO DECIDE. “It is my opinion ... that Lindsay Clancy was criminally responsible,” he said. He rested it on the ordinariness and control of the day, on the planning before it, which he called significant, on what he described as an avoidance of witnesses, on the returned call, and on the appointment the day before, at which she denied suicidal or homicidal thoughts, discussed future treatment and showed him no sign of psychosis in the record. Boston Globe, 9:55 and 9:58 a.m.; NBC Boston, 9:57 a.m.; CT Insider, 10:04 a.m.
• THAT ENDED THE COMMONWEALTH’S QUESTIONING, AND THE DEFENSE STOOD UP. Kevin Reddington began his cross-examination where he began the last two, on what the witness is getting for the work. Dr. Saathoff told him he is not paid for the testimony himself: he draws his university salary, and the University of Virginia handled the contract with the prosecutors. “The university’s getting paid,” he said, and he did not know what it had billed the district attorney’s office. He agreed he was first approached about the case early this year but not formally retained until April, and — the point Reddington has put to witness after witness — that he examined the defendant over Zoom rather than in a room with her. Boston Globe, 9:59 a.m.; NBC News, 10:02 a.m.; NBC Boston, 10:04 a.m.
• KEVIN REDDINGTON PUT THE CALENDAR TO HIM. The prosecutors first approached Dr. Saathoff in January, the contract with his university was not settled until April, and on East Idaho News’s account he finished his assessment on June 4 of this year — more than three years after the night he was asked to give the jury an opinion about. Reddington made the gap the point, and the witness agreed with him about what it costs: there “are benefits,” he said, to evaluating someone “closer to an event.” He added that he had been aware of the case but “didn’t specifically know” that the prosecution had engaged other medical experts, though he said that is usually how it goes. Boston Globe, 10:01 a.m.; East Idaho News, 9:55 a.m.; NBC Boston, 10:04 a.m.
• KEVIN REDDINGTON PUT THE ACCUSATION PLAINLY. The forensic psychiatrist “tailors his opinion to the organization who has hired him, in this case it’s the District Attorney’s Office,” Reddington told the jury, as East Idaho News reports him, and turned from there to a working life spent, on his telling of it, alongside law enforcement. East Idaho News, 10:06 a.m.
• KEVIN REDDINGTON READ THE WITNESS HIS OWN RESUME. Reddington took the witness through the work he has done and who he has done it for: treating people with mental illness in the Virginia state prison system, some of them serving life sentences; two or three inmate evaluations for the federal Bureau of Prisons since 2019; the Department of Justice and the Virginia attorney general’s office; the FBI, the Air Force, and crisis-management work for other governments, Canada, Jordan and Australia among them; and his university, where his work includes college students. He has no practice of his own outside that. When Reddington put it to him that he does not advocate for the prisoners he treats, Dr. Saathoff refused the characterization — “No, that’s not true at all.” The point of the list arrived as a question, whether it was fair to call him a government man, and it did not survive the prosecutors’ objection. Boston Globe, 10:12 and 10:18 a.m.; NBC News, 10:17 a.m.; CT Insider, 10:17 a.m.; NBC Boston, 10:19 a.m.
• NOR IS IT ON ANYTHING ABOUT PARENTS WHO KILL THEIR CHILDREN. Dr. Saathoff acknowledged to Reddington that he has published nothing on filicide, on East Idaho News’s account. Reddington took the answer and set the defense’s own expert against it, telling the jury that Dr. Phillip Resnick is recognized in that field and moving to put Resnick’s peer-reviewed work before them. East Idaho News, 10:13 a.m.
• HIS NAME IS NOT ON ANYTHING ABOUT HEARING VOICES. Reddington came back to the question more than once and got the same answer each time: Dr. Saathoff has never published an article on auditory hallucinations. He has read the peer-reviewed work on the subject, he said, but written none of it. Reddington then produced a paper on the topic by Dr. Phillip Resnick, the defense’s own expert, whom the witness described as “well known” for his work on parents who kill their children. Boston Globe, 10:17 a.m.; NBC News, 10:20 a.m.
• WHAT HE HAS PUBLISHED IS ABOUT SOMETHING ELSE. After the sidebar the cross went title by title through his own papers, and the list the jury heard was extremist violence and the way risk of it rises and falls in women, socio-political conflict, bioterror, the political radicalization of women, big data applied to national security, and crisis negotiation. Only one of them comes near this case: a study of postpartum psychosis brought on by one particular drug, which the Boston Globe places decades back. Boston Globe, 10:24 a.m.; NBC Boston, 10:19 a.m.
• HE HAS TREATED WOMEN IN POSTPARTUM PSYCHOSIS, THOUGH NOT RECENTLY. Answering Reddington on his clinical experience of the condition the defense case turns on, Dr. Saathoff said he had cared for such patients while he was working at a state hospital, in the late 1980s and again during the 1990s. The Boston Globe puts the number at two. NBC News, on the same exchange, records him holding to the experience, and notes that on Tuesday he had told the jury he treated about half a dozen women with the condition and was an author of some of the earliest work tying it to medication. The defense wanted more than that: “Other than that...?” Reddington asked. Boston Globe, 10:31 a.m.; NBC News, 10:36 a.m.
• HE WAS TAKEN THROUGH HOW THE ILLNESS IS TREATED, AND HOW FAST IT CAN TURN. Asked what he would do for a woman with postpartum depression, Dr. Saathoff described a team assessing the symptoms and treating them, and said those symptoms can look much like depression of any other kind, with disturbed sleep and thoughts of suicide alongside. He could not put a figure on how many women with the condition go on to end their lives — he had no idea of the number, on CT Insider's account. He agreed that the move from postpartum depression into psychosis can be a rapid one. Whether a patient's blood should be tested, he said, depends on her symptoms, her history and what she has been prescribed. NBC Boston records that the women he treated at the state hospital had generally been committed there by a court. Boston Globe, 10:33 a.m.; CT Insider, 10:43 a.m.; NBC Boston, 10:45 a.m.
• THE JURY WAS GIVEN A NUMBER FOR HOW DEPRESSED SHE HAD SCORED. No specific test diagnoses postpartum depression, Dr. Saathoff told the defense, but there is a questionnaire patients fill out, the Edinburgh Postnatal Depression Scale, which he described to the jury as running to 30 points. The defendant was given it a number of times, he said. Her highest score was 23. Anything above 15 “is concerning, definitely,” he said. Boston Globe, 10:39 a.m.
• REDDINGTON ASKED WHAT A SCORE LIKE THAT SHOULD LEAD A CLINICIAN TO DO. Blood work can be helpful in a patient who scores that high, Dr. Saathoff allowed, and a thyroid test can be helpful for a woman after childbirth — that one, he confirmed, was never done on the defendant. Enzyme testing he was not aware of as something typically available or used. He also told the jury that a drug the defendant turned down because she was worried about a rash can, in very rare cases, cause a fatal one. Boston Globe, 10:44 a.m.
• WHAT A BLOOD TEST OR A GENETIC TEST COULD HAVE SHOWN. Reddington kept the witness on the tools available to anyone treating a woman in the defendant's position. Blood, Dr. Saathoff agreed, gives a clinician the thyroid and hormone readings and, for some drugs, the amount of the drug in the patient. Genetic testing — from blood or from a swab of the inside of the cheek — goes to the genes that govern how a body handles psychiatric medicine, and can put a prescriber on notice about a dose or a side effect. The Boston Globe's account of the exchange notes, as background rather than as evidence from the stand, that she was prescribed 13 medications in four months by half a dozen providers, and that no DNA test now in use will diagnose postpartum psychosis or say reliably who is likely to develop it, though that is what researchers are working toward. Boston Globe, 10:46 a.m.
• HE AGREED THAT BEING KEPT FROM SLEEP IS A FORM OF TORTURE, AND THAT INSOMNIA CAN END IN PSYCHOSIS. Kevin Reddington put it to the witness that depriving a person of sleep is used as torture, and Dr. Saathoff allowed that it can be. Asked whether insomnia can carry someone into psychosis, he said it was possible. Insomnia is the symptom he had given the jury earlier the same morning as his reason for settling on bipolar 2, and it is the symptom the defense case rests on hardest. Fox News reports the question reaching him by way of his counterterrorism work. East Idaho News, 10:46 a.m.
• THE DRUG SHE TURNED DOWN, AND WHETHER TURNING IT DOWN WAS REASONABLE. NBC News names the medication lamotrigine and records Reddington refusing to leave it at the word rash: he took the witness through what the skin reaction can amount to, blistering among it, and asked whether a woman who is herself a nurse might sensibly want no part of it. Dr. Saathoff let a long silence go by before answering that “the benefits” of the drug “are profound.” Reddington put the question again — was it a reasonable decision for her to say she did not wish to take it, knowing the side effects — and after another pause the witness gave the defense the answer it wanted, of a kind: “In her mind it was.” Boston Globe, 10:48 a.m.; NBC News, 10:55 a.m.
• THE CROSS WENT BACK TO THE AUTUMN, AND TO WHY SHE WAS SEEING SO MANY PRESCRIBERS. Dr. Saathoff agreed that by October 2022 the defendant “was certainly having difficulty.” He had read a message she sent her mother on October 20 that year, asking her to come because a new anxiety medicine had left her unwell, and he told the jury she had said herself that she was not sticking to a plan on her medications and would have done better if she had. Reddington then put the alternative reading of all those providers to him and closed it off. It was not his understanding, was it, that she was going from prescriber to prescriber to get high. “She was not going out looking out to score drugs … is that fair?” he asked. “Correct,” the witness said. NBC Boston, covering the same stretch, records him telling the jury that the records describe the first twelve weeks after Callan was born as really quite good, with the decline arriving at the end of the summer and the defendant going to doctors including Dr. Jennifer Tufts for help. That outlet gives what she said to her mother as “It’s just really scary and I don’t want to be alone.” Boston Globe, 10:56 and 10:59 a.m.; NBC Boston, 11:06 a.m.
• WHAT DECEMBER LOOKED LIKE, AND WHAT A HOSPITAL MADE OF HER. Dr. Saathoff told the jury the defendant went to an emergency room in the middle of December 2022 saying she was not sleeping and that she felt numb and hollow, and that on December 20 she was seen at Women and Infants Hospital in Rhode Island for its postpartum day program. The program’s view, he said, was that something else would suit her better — inpatient care, or partial hospitalization. Most of the women in it had given birth more recently than she had. The treatment records he read had ruled medication out as the source of what was wrong with her. Asked whether she did what her providers told her to do, and did it at once, he said she attended her appointments. He said she believed her brain had been permanently damaged and would never recover, and that the homicidal thoughts she described went to her husband and her mother; he does not recall her putting them to anyone treating her. By the close of 2022, he agreed, she was reaching out to people she thought could help her. Boston Globe, 11:04 a.m.
• THE WORD “JUST,” AND THE DEFENSE REFUSING TO LET IT PASS. Pressed on whether the dark, intrusive thoughts the defendant reported in the months before January 24 had ever reached her doctors, Dr. Saathoff answered that the homicidal ideation, as he understood it, was “just voiced to her husband and her mother.” Kevin Reddington took hold of the adverb. “‘Just’ voiced? Is that what you just said?” he asked, and then, angrily, on NBC News’s account: “Just voiced, is that like talking about the Red Sox? She’s talking about homicidal ideation of her children.” The Commonwealth objected. NBC News, 11:07 a.m.
• WHO ELSE SHE HAD TOLD, AND WHAT HAPPENED WHEN SHE RANG FOR HELP. Dr. Saathoff said he did not know whether anyone at the children’s preschool had been told about the intrusive thoughts. Reddington asked whether a clinician has done enough by asking someone who says she wants to die only whether she has worked out how; the witness said he was not aware that the question had been put to her on its own. He agreed she had telephoned a suicide line twice, though he could not place the calls in time, and that she spoke to whoever answered about wanting to die. NBC Boston names the service Aspire. What it did, he said, was send her back to the provider she already had: no one there pressed for a hospital bed or moved to have her committed. “They didn’t do anything,” Reddington put to him, on NBC Boston’s account. His explanation was that she had given them no plan — “I know that they were not responsive to her suicidality because she did not indicate that she had a plan.” Asked where the records said so, he answered that he could not point to the place. CT Insider, which reports the same exchange, records a long silence before the witness said he believed the detail had come from the evidence. Boston Globe, 11:11 a.m.; NBC Boston, 11:19 a.m.; CT Insider, 11:30 a.m.
• THE DEFENSE PUT TO HIM THE WOMAN SHE HAD BEEN BEFORE ANY OF IT. Dr. Saathoff said he did not know that the defendant had been a happy person and a good mother before she fell ill, on CT Insider’s account of the cross. He was asked about Dr. Jennifer Tufts, who had been practicing on her own as a psychiatrist for about a month when the defendant came to her: whether that was enough to take on what the defendant brought would turn, he said, on her education. And on the Rhode Island day program, while he agreed the defendant had been told to look for other treatment, he added that she may by then have been past the four-month window he treats as the postpartum period. CT Insider, 11:13 a.m.
• WHAT A LINE THAT DOES NOTHING CAN DO TO THE PERSON WHO CALLED IT. Asked what follows when someone in that state reaches a service that cannot help her, Dr. Saathoff allowed it “could have a very serious effect.” Reddington moved from there to the body, and to what giving up breastfeeding does to a woman who has recently given birth. That turns on the individual, the witness said, and he told the jury the defendant stopped nursing Callan in the autumn of 2022, when she started on Ativan. He agreed with Reddington that giving up nursing acts on a woman's hormones, and that after a birth some hormones and metabolites fall away rapidly, on CT Insider's account of the last exchange before the break. Boston Globe, 11:17 a.m.; NBC Boston, 11:19 a.m.; CT Insider, 11:30 a.m.
• WHAT GIVING UP NURSING DOES TO THE CHEMISTRY OF THE BRAIN, AND WHAT THAT CAN DO TO A WOMAN. The exchange the jury heard around the break moved from hormones to the brain itself. NBC Boston records Dr. Saathoff telling the jury that stopping breastfeeding can act on the neurotransmitters, and then explaining to them what a neurotransmitter is: the chemicals that carry such things as mood and psychosis, working in more than one way. He named dopamine, serotonin and norepinephrine. The Boston Globe has him going further and allowing that the changes in a woman's hormones after a birth and after she stops nursing can bring on “intrusive and hard-to-control thoughts and hard-to-control behavior” — the defense's own case put to the Commonwealth's last witness, and accepted. The Globe adds, as background rather than as evidence from the stand, that the defendant stopped nursing Callan about three months before the killings and had given birth to him eight months before. Boston Globe, 11:59 a.m.; NBC Boston, 11:59 a.m.
• THE 911 CALL, AND WHAT COULD BE HEARD OF HER ON IT. Back from the break, the cross took the witness to the recording of the call her husband made to the emergency line that night. Dr. Saathoff said he had listened to it, and that there was nothing on it from the defendant beyond what Kevin Reddington put to him as “guttural grunts.” Boston Globe, 11:58 a.m.
• HE HAD FOUND IT NOTABLE THAT SHE MISLED HER FAMILY, AND SAID SHE DID IT IN TEXT MESSAGES. Kevin Reddington put to the witness that one of the things standing out in his assessment was that the defendant had betrayed her family by misleading them. Dr. Saathoff corrected the verb — he had said portrayed, not betrayed — and agreed that she portrayed herself to them in a way that misled them. Asked how she had done it, he said it was in her text messages. East Idaho News, 12:01 p.m.
• THE POWDER IN THE WINE GLASS WAS NEVER TESTED. The account of the defendant's own overdose that night turns on crushed medication found in the couple's bedroom, and Kevin Reddington took the witness through how little is actually known about it. Dr. Saathoff said the crushed pills were something Patrick Clancy had seen and reported — “It was Patrick Clancy’s observation,” he told the jury — and that he did not recall having told the jurors earlier that the powder was antipsychotic medication. Asked whether the police had ever established what it was, he said he was not aware of any testing, and he said nothing else recovered from the room bore it out: no pill press, and no residue anywhere but the glass. “There’s no investigation by the police to determine what was in that powder, right?” Reddington asked. “Not that I’m aware of,” Dr. Saathoff said. The Boston Globe describes the vessel as a wine glass; NBC News describes the allegation as pills crushed into lemonade as part of an attempt on her own life. Boston Globe, 12:07 p.m.; NBC News, 12:12 p.m.
• WHAT HER HUSBAND TOLD HIM, AND THE ONE THING THE HOUSE DID NOT BEAR OUT. Dr. Saathoff told the jury he heard no exchange between the defendant and her husband on the 911 recording, but that Patrick Clancy had told him separately that she said she had tried to kill herself. He said there was blood on the floor of their bedroom and could not recall whether there was any on the doorknob. Reddington told him that he and Patrick Clancy had taken medication bottles from a nightstand drawer beside the bed a couple of days after the killings, then asked whether someone in a psychotic state can hold a memory of something that never happened. Could such a person misremember something, Reddington asked, or hold a false memory; the witness said yes to the first and “it’s possible” to the second. The instance he had in mind was the second-floor window the defendant went out of: she had told investigators she cut the screen with a knife before she jumped, and there was no sign the screen had been cut at all. Asked whether he took that for malingering or a deliberate lie, Dr. Saathoff said no. The defense's point, on the Boston Globe's reading of it, was that she was misremembering the details of what she had done that night. Boston Globe, 12:07 and 12:10 p.m.
• THE ACCOUNT OF WHAT SHE SAID IN THE HOUSE THAT NIGHT CAME TO HIM FROM HER HUSBAND. NBC Boston records the cross making the foundation of the opinion explicit. Because nothing the defendant said can be made out on the 911 recording, whatever Dr. Saathoff has told the jury about what she said to Patrick Clancy when he got home is what Patrick Clancy told him afterward. The witness agreed she could not be heard speaking clearly anywhere on the call. CT Insider records the same source behind another detail he gave the jury — that the door of the basement office was shut — and one more thing nobody ever established: Kevin Reddington put it to him that the red drops on the bedroom floor looked like blood and were never tested, and he agreed. CT Insider describes the vessel holding the crushed medication as a tumbler; the Boston Globe has called it a wine glass. NBC Boston, 12:12 p.m.; CT Insider, 12:24 p.m.
• HE HAD TRIED TO REACH HER MOTHER AND BEEN TOLD SHE WOULD NOT SPEAK TO HIM. Dr. Saathoff said he never interviewed the defendant's mother, though he had tried: the prosecutors, he said, told him she would not talk to him, and he did not go to Kevin Reddington to ask for the interview himself. The defendant, he told the jury, had wanted him to speak to her family. It came up in support of something he had said on direct — that she kept how badly she was doing from the people closest to her — for which he pointed to a text she sent her mother saying she was fine at a time when she was not. Boston Globe, 12:14 p.m.
• WHETHER HE HAD TOLD THE JURY SHE INVENTED THE VOICE. Kevin Reddington asked the witness to say plainly what his assessment had concluded about the defendant's truthfulness. “I guess you were telling the jury, in your opinion, that she was making stuff up to make herself look like she’s crazy when she killed her children. Is that what you told the jury?” he asked. “I didn’t use those words,” Dr. Saathoff said. “No, you’re a little more finessed than I was,” Reddington answered. The witness accepted that part of what he had set out to determine was whether the defendant was lying about the commands she said she heard — the male voice telling her to kill the children and then herself. Boston Globe, 12:18 p.m.
• THE TEST FOR INVENTED SYMPTOMS WAS RUN, AND IT CAME BACK CLEAN. Dr. Saathoff told the jury that neuropsychologists have instruments for detecting a subject who is exaggerating or making up symptoms, that another of the Commonwealth's experts gave the defendant such a test, and that it found no sign of it, the one exception being her likelihood of suicide. Asked by Kevin Reddington whether that meant she was not malingering, he said yes. He went further on the defense's own witness: Dr. Phillip Resnick, he told the jury, is a renowned authority on malingering, and Resnick's conclusion was that the defendant had not been lying in any way. Boston Globe, 12:19 p.m.
• A VOICE FROM OUTSIDE THE HEAD, AND WHAT THE DEFENSE'S OWN EXPERT HAS WRITTEN ABOUT THAT. Dr. Saathoff told the jury the defendant described the voice as coming from outside her, and that for some psychotic people the voices are heard from within instead. Kevin Reddington then put in front of him a paper on hearing voices with Dr. Phillip Resnick among its authors — the defense's forensic psychiatrist — which has it that voices are usually heard inside the head and that hearing one from outside is the unusual case. Boston Globe, 12:25 p.m.
• TWO CHILDREN WERE IN THE HOUSE, AND EITHER COULD HAVE BEEN EATING. The cross went back to what Dr. Saathoff had told the jury on Tuesday, when he treated the defendant's account of the hours before the killings as unreliable. She had told him she was taking chicken nuggets from the refrigerator for the children when a man's voice began telling her to kill them; Patrick Clancy's account was that Dawson was already eating nuggets before he left the house for a prescription and takeout, which the witness offered as a sign that she was not a reliable narrator of her own evening. Reddington's answer on Wednesday was that there were two young children in the house, and the food could as easily have been for the other one. Boston Globe, 12:26 p.m.
• A REPORT OF A VOICE COMING FROM OUTSIDE THE HEAD CAN STILL BE A TRUE ONE. Having put Dr. Phillip Resnick's paper to the witness, Kevin Reddington asked him whether a patient who says she heard a voice from outside herself can be reporting it honestly. Dr. Saathoff answered that she can. Boston Globe, 12:30 p.m.
• THE LAST QUESTION OF THE CROSS-EXAMINATION WAS THE COMMONWEALTH'S OWN OPENING STATEMENT. Kevin Reddington read the witness what the prosecution had told the jury when the trial began — Shanan Buckingham's statement that the defendant made the selfish choice to kill her children and herself because she was tired of the life she was living, and that she had manipulated the providers she went to for anxiety, depression and insomnia. NBC News records the passage as also charging her with looking for quick fixes, dropping the treatments she did not care for, and deciding she did not want to try any more. Reddington asked him whether his own opinion supported it: “Do you agree that it would support your contention, sir, or it would not?” “Well there's a lot in that,” Dr. Saathoff said. “I think that statement you read really minimizes what she was going through.” Reddington had no further questions. Boston Globe, 12:30 and 12:38 p.m.; NBC News, 12:38 p.m.
• THE REDIRECT OPENED ON THE YEARS HE HAS SPENT IN PRISONS. Jennifer Sprague took the witness back over his own practice for the Commonwealth. Treating and evaluating prisoners, he told her, calls for the best care that can be provided. He said he has treated hundreds of women in custody who were psychotic, and gave the jury what the illness looks like: delusions, false beliefs, hearing voices, disorganized thinking, and difficulty making oneself understood. Boston Globe, 12:33 p.m.; NBC Boston, 12:41 p.m.
• TWO OF HIS OWN PATIENTS HAD BECOME PSYCHOTIC AFTER GIVING BIRTH. Asked on redirect about postpartum psychosis in his practice, Dr. Saathoff described two cases. One was an 18-year-old, who on NBC Boston's account had just had a child, decided against breastfeeding and was put on a medication; the Boston Globe records that she became convinced she had to kill her baby and turned suicidal. The other was a woman in her twenties showing mania and religious delusions about her child. Both, he said, had reacted badly to a particular drug. The accounts read for this index do not name it. Boston Globe, 12:37 p.m.; NBC Boston, 12:41 p.m.
• HE SAW NOTHING IN HER MEDICAL RECORDS CALLING FOR BLOOD WORK. Jennifer Sprague's redirect came to the tests the defense had spent the morning saying were never ordered. Dr. Saathoff told the jury there was nothing in the defendant's medical records that would have required blood testing, and that her thyroid levels were normal when they were checked in November 2022. Asked what his professional interest actually is, after Kevin Reddington's recital of his writing and his work on extremism and terrorism, he said he has been very interested in public psychiatry and that what matters most to him is working with patients. Boston Globe, 12:42 p.m.
• ABOUT ONE PATIENT IN A THOUSAND GETS THE RASH SHE WAS AFRAID OF. On redirect Dr. Saathoff took up Lamictal, the mood stabilizer the defendant declined because of the serious rash it can cause. He put the risk at roughly one in a thousand, and said starting low and building the dose slowly lowers it further. It is now among the most widely used mood stabilizers in bipolar disorder, he told the jury, and the low starting dose Dr. Jennifer Tufts wrote for her was the standard one. Boston Globe, 12:45 p.m.
• HER SLEEP GOT BETTER AT MCLEAN, AND SHE TOLD HER MOTHER SO. Jennifer Sprague's redirect turned to the insomnia the diagnosis rests on. Dr. Saathoff told the jury the defendant was sleeping better while she was being treated at McLean Hospital in early January 2023, and that later the same month she texted her mother that her sleep had improved. He put the anxiety and insomnia she reported back to September 2022, and said a clinician had noted that autumn that she was finding her children harder work as they got older. Boston Globe, 12:50 p.m.
• THE PRESCRIBING HE WAS BROUGHT IN TO REVIEW WAS, HE SAID, REASONABLE. Asked about the care Dr. Jennifer Tufts gave the defendant over several months, Dr. Saathoff said he had no objection to any of it: the medications were appropriate, and “I felt that the prescribing was very reasonable.” Tufts saw her more than once a week at times and was “very responsive” to what she raised, he told the jury. He said the defendant had severe insomnia while she was on Zoloft and that Tufts took her off it, and that taking her off it was itself a reasonable call. Boston Globe, 12:50 p.m.; NBC Boston, 12:57 p.m.
• THE PRESCRIPTION HISTORY RAN BACK YEARS BEFORE THE ANXIETY THAT SENT HER TO DR. TUFTS. Dr. Saathoff took the jury through the drugs the defendant had been given over time. She had been on Prozac several years earlier, and was prescribed Zoloft after Dawson was born but stopped taking it once the anxiety eased. The anxiety after Callan's birth was the more serious of the two, he said, and it was that which took her to Dr. Jennifer Tufts. When the Zoloft left her unable to sleep, Tufts stopped it and started her on Ativan and Benadryl instead; the defendant, he said, was worried about becoming addicted to the Ativan. Boston Globe, 12:56 p.m.
• THE CRISIS LINE DID NOT HANG UP ON HER, THE COMMONWEALTH HAD THE WITNESS SAY. Kevin Reddington's cross had left the jury with a service that, as he put it, did nothing for her. Jennifer Sprague went back over the same two calls on redirect. Dr. Saathoff agreed that the defendant reported suicidal thoughts but described no plan, that nobody at the Aspire line hung up on her or turned her away, and that the team sent her resources and recommended a day program, a partial hospitalization program or an inpatient stay. NBC Boston, 1:06 p.m.; NBC News, 1:08 p.m.
• THE HOSPITAL THAT WOULD NOT TAKE HER OFFERED HER SOMEWHERE ELSE TO GO, HE SAID. Women and Infants Hospital did not accept the defendant into its postpartum program, and the defense has made that refusal part of its case. On redirect Dr. Saathoff told the jury the hospital put several other kinds of treatment in front of her instead, and that she said she would take them to her own provider — which, on the provider's notes as he read them, she did not do. Boston Globe, 1:03 p.m.
• THE HORMONAL CHANGE THE DEFENSE RELIES ON WAS, ON HIS EVIDENCE, BEHIND HER BY JANUARY. Dr. Saathoff put the end of breastfeeding at October 2022 and said he would not expect the defendant to have still been dealing in January 2023 with the hormonal shifts that follow it. Boston Globe, 1:09 p.m.
• WHAT SHE SAID WHEN HER HUSBAND FOUND HER COMES TO HIM FROM HER HUSBAND. What Dr. Saathoff knows of the moment her husband came upon her outside comes from Patrick Clancy. On that account, she made it plain to him straight away that she had attempted suicide, and the call to the emergency line followed. Boston Globe, 1:09 p.m.
• HE COULD NOT SAY WHEN THE PILLS ON THE GLASS WERE CRUSHED. The crushed medication is the evidence that she tried to kill herself that night, and the cross had taken it apart. Asked about it on redirect, Dr. Saathoff said he does not know when she crushed them. Boston Globe, 1:09 p.m.
• THE COMMONWEALTH OFFERED THE JURY A REASON SHE COULD BE HEARD ONLY GRUNTING. Kevin Reddington's cross had made much of the 911 recording, on which nothing can be made out from the defendant beyond sounds. On redirect Dr. Saathoff said that someone who is hurt, and particularly someone who has overdosed, can lose ground very quickly, so she could have been able to speak to her husband in the minutes before he dialed and not while he was on the line. CT Insider has him also telling the jury that he did not know what time the 911 call was placed, and adds that earlier evidence had Patrick Clancy calling 911 when he found her outside and not going to look for the children until the responders arrived. NBC News, 1:19 p.m.; CT Insider, 1:19 p.m.
• HE SAID THE TREATING PSYCHIATRIST HAD ROOM FOR HER BECAUSE SHE WAS NEW IN PRACTICE. Dr. Saathoff told the jury on redirect that Dr. Jennifer Tufts was able to see the defendant quickly and often because she was a new psychiatrist, and that her plan of treatment looked reasonable to him. CT Insider, 1:19 p.m.
• NEITHER HER PARENTS NOR HER SISTER SAT FOR AN INTERVIEW WITH HIM. The last of the redirect went to the family members the defense said he had never spoken to. Dr. Saathoff told the jury he was aware the prosecutors had left a phone message with the defendant's parents asking to arrange an interview and had no reply, and that her sister told investigators she was waiting to hear from Kevin Reddington before agreeing to one, and never gave one. East Idaho News, timing the same passage 1:10 p.m., describes the approach to the family as emails rather than a phone message. Boston Globe, 1:14 p.m.; East Idaho News, 1:10 p.m.