S03 E05: The Women

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Before we begin, a quick warning that in this show we discuss child abuse, and this content may be difficult for some listeners.

If you or anyone you know is a victim or survivor of medical child abuse, please go to munchhausensupport.com to connect with professionals who can help.

People believe their eyes.

That's something that actually is so central to this whole issue and to people that experience this is that we do believe the people that we love when they're telling us something.

If you questioned everything that everyone told you, you couldn't make it through your day.

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Last week, we covered the events around Beata's death, and today, we're going to get into two of the main characters who've been blamed for it, Dr.

Sally Smith and social worker Kathy Beattie.

I will tell you that these cases, because gender plays such a huge role in the crime itself, as we know from the peer-reviewed research, some 96% of perpetrators are women, I'm always hyper-aware of the gender dynamics that are at play.

I'm a feminist, and it's often suggested that the diagnosis of factitious disorder imposed on another, or munchhousen by proxy, is somehow misogynist in its nature.

And while I don't agree with this take, I see why this hits a nerve.

Women all too often are not believed about their own pain, their own life experiences, and in the professional sphere, their opinions sometimes are not taken as seriously as a man's would be.

So the now popular rallying cry to believe women is really good advice for the most part.

It is a much needed corrective.

But there isn't just one woman in this situation, there are several.

So it's not so simple as choosing whether or not to believe women.

It's which women we should believe and whose word is supported by evidence.

In watching the Netflix documentary, one would believe that Dr.

Sally Smith and Kathy Beatty are the villains of this story.

Both Kathy Beatty and Sally Smith are now out of the lawsuit, but there is no doubt about the impact on their lives that this film and the media coverage around it have had.

Regardless of the the truth, it's likely that many will remember them as the villains of the Kowalski story.

So, what we're going to try to get to the bottom of today is: is there any evidence that they actually did anything wrong?

Now, in watching the film, you'd think that it is pretty easy to get a child separated from their parents.

Here is Kowalski family attorney, Deborah Salisbury, talking about this.

These types of cases are actually very common.

Child Protective Service investigators have incredible power to remove children.

All they have to prove is that there's probable cause that there could be harm to the child.

So just to clarify, CPS does not make the choice to remove children from their parents.

That's up to the courts.

But nonetheless, let's begin with social worker Kathy Beattie.

In my initial watch of the film, She really stood out to me as the most possibly questionable character.

The film and much of the media coverage of this case focuses in on three big issues about Beattie: a previous arrest for child abuse and two incidences of behavior with Maya that may have crossed some lines while she was actually working with her at Johns Hopkins.

So, let's begin with the story of this arrest.

Here's an account of it from the Netflix film: Who stands your name for the record?

Catherine R.

Beatty.

Something didn't seem right with her,

so we googled her name.

The first thing that came up was she was arrested for child abuse.

So here's an excerpt from a Tampa Bay Times story about this incident.

My producer, Tina, is going to read it for us.

The incident started when a boy, a client at the Suncoast Center for Community Health, walked into an office there June 12th, according to a police report.

He then ignored a manager who asked him several times why he was there.

What happened next stunned other employees, police said.

The manager, Catherine Beatty, grabbed the boy's head, causing him to fall down, the police said.

Beatty placed both knees on the boy's chest.

The boy's face turned red and he said he couldn't breathe.

According to an affidavit, Beatty replied, yes, you can.

So I'm sure like most parents, I have a pretty visceral reaction to this story.

Beatty was arrested on one count of felony child abuse.

The charges were eventually dropped against Beatty, but as we've discussed many times on this show, charges get dropped all the time for myriad reasons.

This does not exonerate her.

And this conduct was bad enough that she was fired over it.

So while there may not have been enough here for criminal charges, this is definitely upsetting.

I want to say that I have met numerous child protection workers in the course of my work who are doing really challenging work, such as Susan Ryle, the CPS supervisor we spoke to about the Britney Phillips case, and we're going to hear from a bit today.

And many of them are really wonderful people, but the child protection system is a troubled and fraught institution, to say the least.

So I don't have much more to say about this arrest, except that while it's probably not legally relevant to the current case, since Kathy Beatty has been dismissed, if I found out that the social worker who was watching my child had been previously arrested for abuse, I would certainly be pretty uncomfortable.

So that's valid.

So what actually happened between Kathy Beatty and Maya while she was at the hospital?

One incident concerns some photos that were taken of Maya before before she was released briefly from the hospital into her uncle's custody to attend a couple of doctor's appointments and a court hearing.

Here is the depiction of those events from the Netflix film.

Yeah, Kathy Beatty came over to my bed and she was like, if you want to go to the court hearing, I have to do this.

So risk management made the decision to have these pictures taken of Maya.

Yep.

She removed my clothes.

She was in her sports bra and a pair of shorts.

Held me down,

took photos of me.

We took pictures of her arms, her legs, her face, and her stomach.

I was screaming, crying, yelling no.

She did not want you to take pictures of her like that, did she?

She did not.

I could not have made it any more clear.

But you went ahead and took pictures of her anyway.

Unfortunately, we did.

What steps were taken to call the parents and ask whether you could take pictures of their child like this?

We can call the parents.

This is certainly disturbing to listen to, but it's my interpretation from the documents that they were taking these pictures because they needed a record of Maya's physical condition when she left the hospital in case there were differences when she returned.

So from the documentation, it appears that there were two options for having these photos taken.

They could either drive Maya down to the DCF office and do it there, or they could do it at the hospital where those around her were at least not complete strangers.

And as to why they didn't contact the parents to ask them for permission, the parents didn't have custody of Maya at this time.

The state did.

Again, I understand why this episode could have been really upsetting for Maya and upsetting for her parents to learn about, but it appears that DCF was requiring these photos to be taken in order to release Maya from the hospital.

So there we are.

So the next matter.

are some disturbing allegations about Kathy Beatty's conduct with Maya.

Here, again, is from the Netflix film.

Kathy Beatty told me that I was going to go into a foster home.

She told me that my mom was in a mental institution.

She told me that she was going to end up adopting me.

Did you ever sit Maya

on your lap?

Yes.

Were you hugging Maya?

I think that we provide comfort to a lot of kids.

So

probably why she was sitting on my lap, I'm sure I did hug her.

Do you think Maya liked you?

Um, yeah, and

I also think that there were times that Maya was very mad because I happened to be the face of the hospital.

So, there were several incidences during the course of Maya's stay at Johns Hopkins where Kathy Beattie had some physical contact with her, where she hugged her, where she had her on her lap, and in one instance where she kissed her on the cheek.

Kathy Beattie has been dropped from the suit now, but the original charges against her framed these incidences as sexual assault.

These incidents were addressed in Kathy Beatty's depositions, where she mentions that DCF does allow workers to have physical contact with children to provide comfort.

So as with many things in this case, there's just no way for us to know.

There's a situation where this conduct really could be appropriate.

You know, as a parent, I obviously want to make sure that any adult who has contact with my kids isn't making them uncomfortable or crossing any lines.

But, you know, my daughter hugs her teachers at preschool when I'm not there.

She cuddles family members when I'm not present.

Kids need affection, and this is recognized in the guidelines from DCF.

At the same time, As a parent, I've noticed that there's a lot more conversation these days about getting a kid's consent when you're giving them affection.

So not just grabbing them and hugging them and kissing them, you know, making sure that that's okay with them.

And at the end of the day, this is just one that I I feel really conflicted about.

On the one hand, this was a child that had been separated from her family, and you wouldn't want her to not be receiving affection from anybody during this stay.

I mean, I see where that wouldn't be good for her also.

But it's also really important that if she was getting physical affection from an adult, that that adult had her consent.

And again, from these documents, it's just unclear.

Kathy Beatty does mention about one instance where Maya actually asked to be put on her lap and these other instances,

it's just unclear.

So interestingly, in the deposition, they never did address the comments about Kathy Beatty wanting to adopt her or any of those comments about her mom being in a mental hospital.

So I'm not sure if that just wasn't deemed relevant for that conversation or what happened there, but Beatty never commented on it.

So what I can address is whether Kathy Beatty herself was responsible for how much Jack and Beata could see and communicate with their daughter.

Here is their description of that from the Netflix film.

I don't know if it was questioning Maya on her treatments or what they're giving her or certain things that she can't discuss with her daughter.

But unfortunately, Kathy Beatty accused Beata of being inappropriate during that phone conversation.

And she tried to get Beata's privileges suspended.

Beara, as strong as she is,

it just destroyed her.

This is something that happens a lot, unfortunately, where social workers carry a lot of the blame for decisions that were made above their heads.

Now, it does appear from her testimony and from some of the other documentation that DCF gave the hospital some leeway in how to enforce their no-contact order, which makes sense as the hospital and the people who worked there were the ones who were actually on on the ground with Maya.

But this would have been a back and forth between the doctors, the hospital risk management team, and Kathy Beatty herself.

So it's not really accurate to paint her as some single bad actor in this.

So what do we know about these interactions?

Was Kathy Beatty working overtime to keep them apart?

And if she was, why might she have been doing that?

So there are documented instances in the records that Maya's progress, they felt, was impeded by some of these visits with Jack and Beada, and that they weren't being very positive about her health.

And so that could give us some insight into why they were putting further restrictions on these parents.

And that's something that we've talked about a lot in these cases in terms of no contact orders or supervised visitation.

That if there is a fear of abuse, then there's also a fear of manipulation of the child.

And so that is my interpretation of why these restrictions became so harsh.

Now, whether or not this is the right call, I just don't have enough information to opine on that.

So as to the claims that have been previously made and that are now playing out in the course of the trial about Maya not being allowed to practice her religion because she was not allowed to have religious artifacts or wafers and holy water, This is just standard protocol for a child who is in the midst of a medical child abuse investigation.

I understand why this might look harsh and unnecessary on its face, but to someone who is familiar with how these investigations play out and the kind of things perpetrators will do when they are separated from the victim, this is really important.

They need to err on the side of caution for the child's safety.

I have heard of incidences where a perpetrator has poisoned their child or has used something to manipulate them that they are leaving in their room or sending along with a caregiver.

Okay, so that's Kathy.

And then we have Dr.

Sally Smith, a respected doctor with nearly three decades of experience working child abuse cases and a mother of two herself.

But if you've heard of her, it's more likely you know her as the villain from Take Care of Maya.

Here again is the film.

At one point, the nurse walked out of the room and in walked this woman with dark hair.

Do you solemnly swear affirmative you're about to give in this case is is the truth, the whole truth, and nothing but the truth?

I do.

State your name for the record.

Sally Marie Smith.

So who is Dr.

Sally Smith?

What do we know about her?

She's the mother of two grown children and has clearly, with a glance at her resume, dedicated her career to protecting kids.

She is not only board certified in child abuse pediatrics, she was certified in January of 2010, making her one of the first in the nation to do so.

As a reminder, here's a bit from our conversation with Dr.

Carol Jenny, who was instrumental in establishing this designation.

And she's telling us a little bit about what it entails.

Child abuse pediatrics is a board-certified subspecialty of the American Academy of Pediatrics.

So in 2009,

we had the first board exams were given and the subspecialty of child abuse pediatrics was established.

What happened was, you know, know, we started doing this in the 1980s, early 1980s, and really since then, the amount of knowledge has just burgeoned.

And, you know, in the same way that cardiology or hematology or oncology, all the other specialties became so technical and there was so much knowledge that had to be absorbed to do it well.

The same thing happened in child abuse pediatrics.

And we realized that there was so much that a generalist couldn't absorb.

And so when I started doing this in 1983, there were three or four articles in the literature.

And now there are thousands published, you know, every specifically on child abuse abuse.

Okay.

So in 1993, we went to the board of pediatrics and we asked to establish this as a, I'm sorry, 2009, we asked to establish this as a board-certified subspecialty.

At the time of this case, Dr.

Sally Smith was employed by both DCF and the Suncoast Center, a non-profit child advocacy center.

Here again is our Florida doctor friend explaining that system to us.

And just as a reminder, the film's own production company describes this as a for-profit system.

This concept of for-profit is not correct.

The idea is that the foster system was privatized, meaning it was the portion of the system, the reporting system is that the foster care portion is now privatized.

So it's under these blanket companies that are private organizations that per county, there's so many of these organizations that I guess are involved in actually, if a child is fostered or placed into foster care, that that's when these private companies are involved.

However, they are still non-profit organizations.

So they are not for-profit, they are privatized.

And to be honest, the whole concept of it, which there's a question if it works, don't get me wrong, but is that the money is allocated appropriately amongst all of these organizations so that every child gets the same treatment or the same care once, you know, once the foster system is involved?

Dr.

Smith also had admit privileges at Johns Hopkins.

So, the idea that Dr.

Smith somehow just didn't properly make herself known isn't quite correct, though, this is one of the many things that the Kowalski team has used against her.

And this idea is also put forth by the film.

Here's that clip from the Netflix documentary: She never stated who she was.

She just walked in, looked at me, looked at Maya.

She came in and she acted like a regular doctor that worked for the hospital.

And she started to ask questions.

If they would have known who she was,

we would have never spoken to her.

It also came out this week during Jack Kowalski's testimony that Beada did know who Sally Smith was and who she worked for because she sent him a text message to that effect.

It's unclear to me what the Kowalskis are intimating would have played out differently if they hadn't spoken to Dr.

Smith.

You know, her main job here was to review records, not to get information straight from the parents.

Though it appears from some communications from Beata that surfaced this week in trial, that Beada did have a longer meeting with Sally Smith where she gave a medical history.

So I believe that that happened as well.

Now, what's clear from this documentation is that the Kowalski's lawyers have tried to paint Dr.

Sally Smith in the worst light possible.

Here is an excerpt from a scathing letter that lead attorney for the Kowalskis, Gregory Anderson, sent to Dr.

Sally Smith early in the case.

This is read by our sound engineer, Jeff Gall.

There is no question that Dr.

Smith bullied the Kowalskis and knowingly kept up the pressure on Beata to conform to Dr.

Smith's course of action and treatment for Beata's daughter, Maya.

There is no question Sally Smith did everything possible to humble, humiliate, disenfranchise, and dissolve the loving, supportive, eternal parent-child relationship.

There can be no other conclusion.

Now, in reading the depositions from Dr.

Smith herself and those of her employers, it's clear that the Kowalski team took a number of strategies to try and pin down something that Dr.

Smith did wrong.

So one thing they accused her of was violating HIPAA by reading Maya Kowalski's medical records.

And as is pointed out to him by her employers numerous times, records are not subject to HIPAA under the context of a DCF investigation or if an expert is called in for a consult about whether or not abuse might be happening.

Two, they take great pains to make it sound as though Dr.

Smith somehow just went rogue and ginned up child abuse accusations.

all on her own accord.

The extensive documentation on this case does not bear that out.

Johns Hopkins called it in and she investigated from there.

She found what she found.

They make a big deal of the call from Tampa General, that's the one from nurse Bonnie Rice, being screened out originally.

So here are a couple of quotes from lawyer Gregory Anderson, the lead attorney in the Kowalski case, in his own words.

during the deposition of Lori Elbow, who is one of Dr.

Smith's bosses.

And this is one of his several attempts to really make something something of this.

Here again, our wonderful sound engineer Jeff Gall.

Are they allowed to dig up things and make an abuse case themselves?

Go through records and put together a story equaling abuse when no one has complained of it?

But of course, there had been complaints of abuse, both from Tampa General and the ones from Johns Hopkins, which are what kicked off Sally Smith's record review.

Nonetheless, Anderson doubles down on this fictional scenario and asks her employee if Dr.

Smith would be disciplined if she had done such a thing.

Just so the parents of Florida understand this, just so the citizens of Florida understand this, Suncoast Center does not feel the need to discipline its investigators who go out to create child abuse scenarios.

You know, Madam Court Reporter, read my question back.

It was such a good one.

So again, there is no evidence that Dr.

Sally Smith did anything to, quote, create a scenario.

There were many doctors with concerns.

Dr.

Sally Smith collected as many of the records as she could and compiled first first her primary report for the shelter review and then her longer 45-page report, which has so far not been released.

But we know that it was her professional opinion that medical child abuse had occurred.

Something really interesting did come up in this line of questioning, which is that Anderson was asking how this behavior of Beada's could fit into the definition of medical neglect.

And this hits on a really important point that has come up before.

We know that many states in the U.S.

do not have any kind of an official designation for medical child abuse on the DCF or CPS forms.

And so they end up having to shoehorn it into medical neglect.

And this is something that we talked to former CPS supervisor Susan Ryle about.

This makes it very difficult when you're going to court, civil court or criminal court, depending on who you're dealing with.

If we're dealing with some of the people we've worked with, judges, ADAs, et cetera, that we can work with and talk to and explain, that's one thing.

But most places in the state of Texas, as well as if we get a family court judge that knows nothing about it.

You're really having to start from scratch trying to explain the existence of a type of abuse that they may never have heard of.

Exactly.

Rather than, and not that it's all about paperwork, but you don't even have a box for this.

If it's real,

why isn't there a category?

And just an aside here, after reading many hundreds of pages of Gregory Anderson questioning witnesses and watching him these past three weeks of the trial, if Jack Kowalski would like to place blame on someone for his financial situation, he might want to start with his lawyer, who managed to somehow ask the same question 18 different times in each of his depositions.

Both the film and the Kowalski's lawyers also suggest that Dr.

Sally Smith somehow financially benefited from separating families.

Here's a clip from the film about that.

In Florida, the child welfare system is privatized.

So when Sally Smith reviewed Maya's case, she was an employee for the Suncoast Center.

That center assists in investigating child abuse allegations in Pinellas County, where All Children's Hospital happens to be located.

Children in Pinellas County are almost two and a half times more likely to be removed from their families than the state average.

I now refer to it as the child welfare industry.

So let's start with this alarming sounding statistic about Pinellas County, which appears to have originated in Daphne Chen's reporting and was repeated in the film and in Dean Neary's New York magazine piece.

So there are a number of things to say about this statistic, and I did speak to a data scientist friend about this, but the big takeaways here are, number one, this statistic about family separation doesn't specify why these separations happen.

And one thing that we do know from the data about separations in this country overall is that some 75% of family separations do not happen because of abuse allegations.

They happen because of issues related to poverty or substance abuse.

And so this statistic does not account for any of those differences.

Also, importantly, Pinellas County from year to year trades off this designation of having the most family separations with the other most populated counties in Florida.

So needless to say, this is a very complex matter and to pin it on one child abuse pediatrician is just completely misleading.

And while we're on the topic of financial incentive, let's talk about salaries, shall we?

Because we do have some of that information.

So at the time she was deposed, Dr.

Sally Smith reportedly earned a combined $185,000

for her work on behalf of DCF and Suncoast, who jointly paid her salary.

So this is a good salary.

but it's not megabucks for a doctor with almost 30 years of experience.

And the reality is people don't go into this line of work to make the big money.

And also, the idea that Sally Smith's salary is somehow tied to the number of children that she helps to separate from their family is just flatly ludicrous.

There is no such incentive.

And I'd also be very curious to know what Dr.

Kirkpatrick and Dr.

Hannah's annual salaries are.

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The end of the Netflix film lands a damning blow as they bring out a chorus of voices of parents who claim to have been falsely accused of child abuse by Sally Smith.

Here are some of those voices.

So our son Leo was born with a rare genetic disorder.

I noticed that something was wrong with his right leg.

She was crying and moving her arm in a weird way when we picked her up.

In the film, these parents are presented with their first names only, and they gave very little detail as to why they believe they were falsely accused.

These stories are also included in Daphne Chen's reporting, and she makes an appearance in the film as well.

You don't get to the truth by just accepting what's in front of you without questioning it.

And they come up in some of the depositions, namely in the deposition of one of Dr.

Smith's bosses, Laurie Elbow, who rightly points out that cases don't proceed to prosecution for myriad reasons, and that this in and of itself is not evidence of a false accusation on Dr.

Smith's behalf.

So I would imagine that for a viewer that doesn't have proper context, watching this chorus of voices at the end might strike them as, wow, that's a lot of parents who are saying that this doctor falsely accused them.

And, you know, where there's that much smoke, there must be fire.

But let's take a step back here.

So in her New York magazine interview, which is one of the only interviews to my knowledge that Dr.

Smith has done about this case, she estimates that she's done about 3,000 child abuse evaluations throughout the course of her career.

And of those, 12 families over the course of those 30 years have registered complaints.

So since we're doing math in this episode, that is 0.004%.

And again, the fact that their cases didn't proceed does not tell us about whether this abuse happened or not.

It really seems to me that any child abuse pediatrician over that period of time would would rack up a decent number of angry parents.

And importantly, no evidence is offered that any of these parents were falsely accused, other than their word on it and the fact that they eventually got their kids back.

This, by the way, contradicts the idea that Deborah Salisbury puts forth early in the film about the courts taking doctors' word as gospel.

This was a huge power struggle.

But no matter what we did, the court repetitively sided with the hospital staff and Dr.

Sally Smith.

I also know from my work with the committee that it is flatly untrue.

It is incredibly difficult to get the courts to take this abuse seriously.

Now, as we'll discuss in the next episode, there was disagreement among some of the doctors, but Dr.

Sally Smith was the only one who looked at this massive bulk of records and who has the experience, let alone the board certification, to determine whether or not abuse happened.

So there is a lot of talk in these articles about, quote, false allegations, about how this kind of thing can ruin a woman's life, about how it can destroy her reputation and sort of follow her around forever.

But Dr.

Sally Smith is a woman.

She's a mom.

So is Dr.

Elizabeth Woods, the doctor who reported my sister and ended up having her reputation completely tarnished.

You know, what about them?

I mean, the comments about Dr.

Smith online are horrific.

And all of this for what?

Doing her job, which she was highly trained to do, to protect kids.

You know, we have this idea that doctors are these invulnerable, powerful beings.

But the truth is, when it comes to how things play out in the media, they are incredibly vulnerable.

A parent can essentially make any claim about them.

And unless there's been a criminal conviction, which we know are very rare, they can't say boo because of HIPAA.

And the report that the Kowalskis are suggesting was so flawed, we can't see it because they won't let us.

As I've been watching the Kowalski trial play out, you know, right now, most of the people we've heard from so far are on the plaintiff's side.

And as I've been watching some of these doctors, Dr.

Wassner's testified, Dr.

Chopra has testified.

We are still yet to hear from Dr.

Kirkpatrick and Dr.

Hannah, but I believe they are going to testify as well.

I've had the sneaking suspicion that one of the arguments that they're trying to make and that these doctors appear to believe is that Munchausen by proxy isn't real.

And as I was digging through the documentation on this case, I discovered that the Kowalski team actually made this part of their official legal argument using something called the Dobert defense.

Basically, they argued that Munchausen by proxy is based on junk science.

So not only did Beata Kowalski not abuse her child in this way, no one abuses their child in this way.

This form of abuse does not exist.

And I will tell you that as a family member and as someone who spends a lot of time talking to families who've been affected by this abuse, talking to survivors, That's really painful because it just completely erases all of our experiences.

And it adds to this gaslighting that we've all already been through in terms of you didn't see what you think you saw.

That thing that happened to you, it wasn't real.

You're making it up.

There will likely be more to say about Kathy Beattie and Dr.

Sally Smith because while they have been officially dropped from the case, they are still involved in this situation.

So we will keep you up to date on anything new that we hear about either of them.

So we've talked so far about some of the reasons that abuse was suspected, but there are doctors in this case, some of them Maya's treating physicians, who did not believe that abuse had occurred.

And in fact, a lot of people in the public seem to agree with the film's take on this case.

It was important to me this season to really get some outside opinions on this case and this matter as a whole.

You know, obviously, many of the people we talk to on this show either have a personal connection to this topic or are experts in the field.

And also, I'm aware of my own biases here, and we try very hard to be balanced and really keep things fact-based, but I just wanted to get some other perspectives on this.

So I sought some of those out, and we are going to hear from some of those folks in the next episode of Nobody Should Believe Me.

Nobody Should Believe Me is a production of large media.

Our senior producer is Tina Knoll, and our editor is Corrine Kiltow.

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