The Evidence of Our Convictions

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We are an unlikely duo, sharing secrets only known to insiders, the inmates and staff of Bader 5, Boston Children’s Hospital’s adolescent psychiatric unit. I am the nurse who blew the whistle that no one heard in 2010, she is the teenager who was imprisoned on Bader 5 for nine months in 2013. WE met for the first time on this past Thanksgiving Day at Yale New Haven Children’s Hospital, where she has been a *medical* patient for the past nine weeks.

I began to know Justina in April 2013. Nineteen Months ago, I was learning all about her from many sources, as one of the first advocates for the Pelletiers. My involvement predated the “Free Justina” movement by at least six months. I looked at her case through the lens of my medical/pediatric nursing background and my psychiatric nursing experience, finding only egregious errors in every aspect of the handling of Justina’s case; costly errors that could not possibly have been decisions based on any reasonable “risk/benefit” analysis, damaging errors for which I could find no justification.

Needless to say, reaching out to Bader 5 clinicians was an exercise in futility, though I was gratified to know I was perceived as a threat. I learned this from two nurses who expressed their fears around being linked to me — both worried about being accused of connecting the Pelletiers with me; neither knew how that connection had actually occurred.

Justina knew very little about me, though when prompted she remembered the tiny fairy in the origami box that I had made for her, an origami crane, and the bracelet I made with beads in her favorite color — blue. She also recalled interesting reactions from nurses to my gifts, and to the mention of my name. But, mainly I had the unsavory association for her of close connection to those who had caused her deep suffering and pain. Rather than exercising her option to banish me from her room, which I could hardly blame her for doing, she quizzed me on names and special “only known to insiders” information about Bader staff. Approximately 10 nurses I knew well were on her list, plus an additional 6 mental health counselors, 2 psychiatrists, a pediatric Nurse Practitioner, 2 psychologists, 1 teacher and 1 occupational therapist. Following each accurate description of a named Bader staff, I noticed Justina becoming brighter and more relaxed. Her courageous challenge of my authenticity set the stage for what happened next; another first for me, added on to a long list of “firsts” that bear Justina’s signature in my life.

We were suddenly relating to each other like old friends. She would share a story from her tragic memoir, an episode of being completely humiliated by an abject disregard shown for her weakened condition by people I know. Unlike most who have heard these stories over the past 5 months, I have witnessed countless unfeeling, uncaring actions carried out with precision by the so-called mental health professionals; the exact ones who appear in Justina’s nightmares — all of them following the “treatment plan.”

It must have been my unflinching validation of her testimony that led her to ask me to explain why even the staff who seemed nice to her one minute could follow this plan in another one. She asked me to explain the indefensible actions of people who chose to coerce her to do what she could not do, and denied her any sort of treatment or comfort for the issues she voiced. “There is no reason,” was my honest reply. “What they did is wrong.”

She accepted that as confirmation of what she felt; but rather than become angry or even upset, Justina changed the topic to concerns she had for other kids she met on Bader — to wondering what help there was on that unit as she saw no one who seemed to benefit. She often repeated these words, “I don’t think he [or she] needed to be there” over and over. I wholeheartedly, and honestly, agreed with her assessments.

During my four hour visit, I saw Justina engaging as a typical teenager with her sisters, her parents and her grandma. She was pleasant and cooperative with the nurses who performed assessments with respect for her privacy and dignity. There were only two episodes that caused her to become emotionally distraught. The first was at the mere mention of a possible “psychiatric evaluation” to be included with more tests that were soon to take place, as her GI issues and severe pain continue to plague her. I find it hard to believe that any nurse or doctor who knows Justina’s history would ever mention the word “psychiatry” to her. I reinforced her right to refuse to participate in anything that made her feel uncomfortable. Psychiatry is anything but a life saving treatment — for Justina it proved nearly fatal.

The second episode of unbridled emotional angst occurred when her mom, sisters and grandma were leaving. It was her dad’s turn to stay over. With a unified, compassionate approach, Justina began to regain her composure, though separating from her mom was agonizing to watch. I helped by offering a timely distraction — requesting my long-awaited photo op with her [an international celebrity]. Her evening shift nurse took the picture of us together using my iPhone.

Looking at our photo hours later, the full impact of my meeting and connecting with Justina began to manifest. Alone, I ruthlessly contemplated the damages: neglect of medical treatment combined with traumatic separation from her family, friends, school, community — and topped off by the abuse she suffered at the hands of my former colleagues. It was becoming more personal, more horrible and more unbearable by the moment.

I have been tested by some very tough kids in every setting where I have encountered children and adolescents who have [for good reason] lost all trust in adults. I accept that it goes with the territory and I respectfully engage without hesitation. Justina’s test evoked an unplanned confrontation with professional nursing standards and values I had developed over the past 40 years, and my belief that I could be of help by continuing to practice as a psychiatric nurse — under the radar — in the only hospital that would hire me after I turned ‘traitor’ at BCH. Justina’s sincerity, courage, and most of all her curiosity penetrated all of the walls I have built to protect my need to not abandon people who become prisoners on locked psych wards — or whatever justification there has been for my being a “double agent.” What I have seen, studied, researched and pondered the better part of the past four years has meaning beyond what I could have intended, simply because I did not know that what happened to Justina was even possible.

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20 COMMENTS

    • Duane,

      When I summarize this case, I begin by saying that Dr. Mark Korson’s patient was hijacked via gross medical misconduct on the part of the pediatric neurologist and the psychologist who encountered Justina in the emergency room at BCH. Though it is true that Dr. Korson did not have admitting privileges at BCH, and that patients are not usually admitted directly to a specialist, which would have been Dr. Alex Flores, the GI specialist who knew Justina and who had worked with Dr. Korson at Tufts Medical Center; even though these two *rules* represent standards in most emergency rooms, the fact that Justina had complex medical issues, and was under the care of a licensed, board certified physician warranted bending these rules. I don’t accept arrogance as a the reason or the cause for negating Dr. Korson’s role in Justina’s care. I call this *hijacking* and the first instance of unsafe medical practice. It was Justina’s health that was being put at risk by this move, and there were 4 more days of neglecting her medical needs before the kidnapping occurred.

      There is also the issue of the so-called psychiatric evaluation performed in the emergency room, that was done without the knowledge and consent of her parents. A psychologist, one of Justina’s and my mutual acquaintances, began to formulate a diagnosis that coincidentally matched her area of special interest. Though this has been the topic of lengthy discussion and debate, I would cite the unethical behavior of this psychologist as the second instance of medical misconduct. Drive by psych consults performed by ambitious young clinicians had become a signature practice at BCH in my, then, three year absence.

      I tried to convey, without further violation of Justina’s dignity, my professional opinion of the medical care she received at BCH. I will be more specific here. I would not call the combination of neglecting her medical needs and imposing agonizing ordeals that resulted in both physical and emotional pain, “medical malpractice”. I would call it, “medical assault and battery”. That is the first of three major crimes committed via the power and authority of BCH department of psychiatry.

      The second crime was kidnapping.

      The third crime was illegal imprisonment on a locked psychiatric unit.

      To some extent, I addressed all three in my letter to Massachusetts Department of Children and Families, Governor Deval Patrick and Attorney General, Martha Coakley on
      January 8, 2014. When Beau Berman of CT Fox News publicized my letter in tandem with Former Federal Prosecutor Barry Pollack’s letter to Massachusetts Department of Public Health, in which Atty. Pollack demanded Bader 5 be closed pending investigation. One good thing happened. Within about 10 days, Justina was discharged from Bader 5. The illegal imprisonment was scaled down, but she was still being held by her kidnappers and her medical needs continued to be neglected. Such was the response by the most powerful authorities in the Commonwealth of Massachusetts to the complaints of two qualified professionals regarding crimes against humanity committed by BCH psychiatrists.

      From April 23, 2013 until I met Justina November 27, 2014, my outrage, emotional pain and frustration were responses to the suffering I witnessed her family subjected to, combined with my worst fears based on what I knew the situation to be. Meeting Justina, initiating a relationship on her terms, led me here– a safe place to tell the truth.

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      • Btw, as it may be good we all know who Justina Pelletier is, should the general public also be informed about the names of the so-called “doctors” who have committed these atrocities? If the justice system can’t take care of this (as it has proven time and again to be incapable of) we should at least know who these people are and ostracize and shame them.

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        • My reply to this comment posted under another comment you made further down this thread–

          Thank you, “B”, for making these points. My first attempt at writing about Justina evoked really strong feelings for protecting her. But, by no means do I feel that anyone who has caused her suffering or failed to protect her (same thing?) should remain nameless, so to speak. However, a complete list of names would fill a book. In my response below you’ll find the tip of the iceberg.

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          • Still, making these names public for anyone is the only way to maybe prevent other people to be harmed by those same unethical individuals and shame them in the process. If we can’t count on the justice system that’s the only recourse we have.

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    • @ Discover and Recover,

      I share this spirit !
      Your comments resonate with the part of me that has struggled against the suppression of truth that is the most damaging for Justina. her family and everyone who is struggling against the tide of the latest scourge of child psychiatry.

      I am not unique in both trying to change the ‘system’ and informing the public, or whistle blowing from the inside of the system. Like the nurse who is speaking out in Minnesota (posted here today), all of us ” nurses trying to do the right thing”have to learn to walk across a mine field just to get media attention. In 2009/10 here in Boston, I failed– though I did try – very hard.

      We have to start somewhere– and we have to gain momentum-
      In Solidarity– I hope,
      Katie

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  1. Katie, people like you, who have risked and lost their jobs for doing what is right, deserve a lot of credit. It is easy for people to talk from a distance, but incredibly hard to speak out within the culture of complete disregard for human rights and dignity that is psychiatry.

    It was amazing to me to see the literally tens of thousands of people working to free Justina. It was hard for me to believe, though it surely should not have been, to see the establishment liberals who run the State of Massachusetts ignore this outpouring of support for a year.

    Your courage and commitment are greatly appreciated.

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    • Thank you, Ted. I really appreciate your sensitivity to the obstacles to doing what is right within the nefarious cult[ure] that is psychiatry, but I have to own up to the requirements of my nursing license, and put “doing what is right” in proper perspective. Protecting vulnerable people from harm and abuse in hospitals, as well as all health care settings IS spelled out clearly by the American Nurse’s Association code of ethics– goes with the RN license.

      Speaking out on the inside of those locked doors is as difficult as it is dangerous for everyone–inmates and staff, though the inmates are in the most precarious position of all.
      Owning up another level, I have to point out that risking a job that has become an endless painful austerity; that cannot be anything else unless big changes happen fast, is not all that terrible. On the other hand, when an inmate, or parent, family member speaks out, the consequences are severely life altering. It is well worth risking one’s job as a nurse to protect those who cannot walk out of those locked doors. And recently I learned that those nurses I knew, who kept their jobs on Bader 5 , have for all intents and purposes, lost any claim to being nurses — and perhaps their minds as well.

      What you saw from the “establishment liberals who run the State of Massachusetts” is the evidence of the power of psychiatry that has been pumped up exponentially by :Medical Child Abuse and Somatic Symptoms Disorder, Child psychiatry’s two most recent achievements,that flew under my radar until the Boston Globe article [finally] came out late December 2013. As professional advisor, family advocate or whatever title I was given, I know that neither of these terms were shared with Justina’s parents. I am grateful to the Globe for sharing these well kept secrets. I was up to speed a few days before I wrote the “DCF letter”, having read the text book on Medical Child Abuse and several commentaries on SSD. It is just as difficult get information from Bader clinicians as it is to share information with them. This shroud of secrecy is a focal point, I think– and it has nothing to do with HIPPA.

      On this site, I have read very compelling arguments for calling psychiatry a religion as opposed to a medical specialty. In that vein, I think that there is an explanation for what you saw as the impotence of government here in Massachusetts, or rather, an appropriate analogy imbedded in our constitution, it is; the separation of church and state. Makes no difference which state one resides in, this analogy applies. What compounds the potential for horror stories like the one the Pelletiers have lived, is the authority that our society has granted to medical doctors, while failing to note psychiatry doesn’t fit into this category.

      Isn’t it bizarre, that you or I could very easily determine, given all the facts presented to the juvenile court judge at the first hearing on February 15, 2013, that it is dangerous to disregard the medical advice of the qualified, renowned physician who was treating Justina, and by day 5 was actually being desperately sought by Justina and her parents? Go against all three?? That is absurd enough, but it was based on the absurd recommendation of the Pediatric Child Abuse specialist at BCH– who never saw Justina or met her parents– and she got her story from– psychiatric clinicians. I think it is important to know that the judge could not make the most reasonable decision, because, he is not a doctor. The highest ranking doctor was Alice Newton- Pediatric child Abuse Specialist , making the diagnosis (by proxy-how ironic), Medical Child Abuse– parents seeking unneeded medical treatment. End of story.

      Even a judge cannot do the right thing within the culture of complete disregard for human rights and dignity that is psychiatry.

      Justina’s Face book page, “Miracle for Justina” explains how she got out of this mess– a miracle it was– and I pray more are on the way.

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    • Ted: I think that it is crucial as you point out here, that it is establishment liberalism at fault. I am no fan of talk radio, Fox News or the Wall Street Journal, but I feel that establishment liberalism and political correctness is the biggest obstacle to progress not senior citizens who get their view of the world from right-wing media. I heard one callous person remark that the Peletier family got what they deserved because they consorted with right-wing types. Our country is not divided. The two wings of the establishment are promoting wars around the world, and are trying to shove a corporate coup in the form of the TPP down our throats.

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    • @madincanada,
      Your son is fortunate to have your empathy and understanding. There is no rational explanation for robbing vulnerable people of their humanity. Those in positions of professionally sanctioned authority behaving this way are truly despicable –.

      I hope, that like the young adults I have met during their painful ordeals as psychiatric inmates, your son will choose not to accept the labels or the mistreatment around them as any thing but the ignorance of rude people– better to ignore them, best to avoid them all together.

      I think as nurses go, I would be considered ‘old school’ in my philosophy and practice- by today’s standards that makes me a hero, I guess–though it really is nothing extraordinary.

      I value your kind words of praise, knowing what has inspired them–
      Thank you.

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  2. I was fortunate, and am grateful, to have run into ethical and decent nurses, too. The current psychiatric system is deplorable, insane, and inhuman. The psychiatrists should be ashamed of themselves and their inane, materialistic inspired stupidity.

    I hope and pray for more decent people working within the system, like yourself, to stand up against it. Thank you for fighting against a sickeningly paternalistic psychiatric system set up by those who are seemingly incapable of comprehending the importance of utilizing and valuing both the right (male) and left (female) sides of their brain.

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    • @Someone Else,
      ” a sickeningly paternalistic psychiatric system set up by those who are seemingly incapable of comprehending the importance of utilizing and valuing both the right (male) and left (female) sides of their brain.”

      Fascinating assessment. I wonder if you have discovered a brain disability that may perhaps result from maltreatment of vulnerable human beings–?

      Many seem to be reaching the conclusion that the longer one retains gainful employment by engaging in practices that disregard basic human needs and rights, the sicker he/she will become.

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  3. B. ,
    Good point. I did name them in my letter to DCF- here are the pertinent paragraphs:

    [ link to full text/letter to DCF:
    http://tribwtic.files.wordpress.com/2014/01/higgins-letter-pdf.pdf

    ” As advocate for the family, I informed Department of Mental Health licensing director, Liz Kinkead of the breach of law regarding Justina’s committment to a locked psychiatric unit and was told that DMH was deferring to the medical expertise of Boston Children’s Hospital”. Justina has no history of “serious mental illness”, nor did she exhibit behaviors that indicated she was at risk for harming herself or others. Justina continues to be held against her will on this locked psychiatric unit, licensed by the Commonwealth of Massachusetts Department of Mental Health, on the authority granted to attending psychiatrist, Dr. Colleen Ryan, presumably to prevent harm that would be caused to Justina by the medical care her parents would choose to pursue from board certified, licensed metabolic/genetics specialist, Dr. Mark Korson of Tufts University Medical Center, who had been treating Justina successfully for over a year..Justina was forced to accept her imprisonment to relinquish her basic human rights because it was deemed “unsafe” for her to have access to the medical care she expected to receive at BCH. ”

    ” Beyond the obvious apathy and denial of reality each of these professionals has shown, that becomes more egregious as the level of formal education and trust placed in them increases, is the astounding absence of intervention by Dr. David Demaso, Chief of Psychiatry , BCH and Dr. Gordon Harper, director of child & adolescent services at the Massachusetts Department of Mental Health. ”

    Totally agree with you, on this, B.– here is the last sentence of the letter- the reason we both know that naming names is vital:

    “…like so many cases of child abuse/neglect I have seen over the past 40 years of my nursing career, this abuse was perpetrated and continues because of the shroud of secrecy all abusers demand. ”

    I don’t know what the justice system can take care of– only that these matters have not been appropriately presented to the justice system– yet.
    No charges filed– only complaints and outrage– so far.

    Best,
    Katie

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  4. Dear Katie – Bless you. I have long followed Dan’s story and been in touch with Mary Weiss – we each lost sons to psychiatry. I am proud of the profession of nursing that Dan’s nurse has come forward and am touched deeply at this holiday time to read of your courage as well.

    It is important that all of us who can reach deep into our own humanity and knowledge of what is right and true and do the right thing.

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