S03 E02: Shelter

Speaker 1 True Story Media.

Speaker 3 Nobody Should Believe Me is a production of Large Media.

Speaker 4 That's L-A-R-J Media.

Speaker 9 Before we begin, a quick warning that in this show we discuss child abuse and this content may be difficult for some listeners.

Speaker 9 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.

Speaker 1 Hello, I have exciting news. I am officially taking this show on the road next year.
I'm going to be doing a series of Nobody Should Believe Me live shows next March.

Speaker 1 I will be in Los Angeles on March 7th at the Regent Theater. I'll be in my hometown, Seattle, at the Triple Door on March 18th.
Then I'm headed to New York City for a show at Sony Hall on March 25th.

Speaker 1 And I'll be wrapping up in Chicago on March 26th at The Den. Tickets for all shows are on sale now.
You can find a link in the show notes or on our website.

Speaker 1 We're going to have special guests, meet and greets, and more at these shows. We're going to have a great time.
So go get your tickets now. Hope to see you out there.

Speaker 1 Many of you know that I was an author before I was a podcaster, and those worlds collide with my new audiobook, The Mother Next Door, Medicine, Deception, and Munchausen by Proxy, which I co-authored with Detective Mike Weber and which I narrate.

Speaker 1 If you want to dive into these three fascinating cases, you can listen wherever you get your audiobooks. Here's a sample.

Speaker 1 You busy? Alana said, leaning against the doorway of Mike's office. We got another Munchausen by proxy case.
This one is ours. You interested?

Speaker 1 Of course, Mike told her, somewhat taken aback. Wasn't this abuse vanishingly rare?

Speaker 1 Alana deposited the voluminous CPS report about Hope Yabara on his desk. Mike had worked dozens of child abuse cases by this point in his life.
He'd seen children subjected to unimaginable horror.

Speaker 1 He thought he had seen the absolute worst of humanity already, but nothing could have prepared him for what he was about to discover about hope.

Speaker 15 Every investigation begins with a question, but this film starts off with an answer.

Speaker 18 We as parents tried to do the best we can for our children, but there's nothing that could have prepared me for what I went through.

Speaker 18 Nothing.

Speaker 18 Beada and I had a beautiful family.

Speaker 18 But then Maya started to get sick.

Speaker 20 Maya had advanced complex regional pain syndrome, and we know what the best therapy is for it. It's called ketamine.

Speaker 18 We're just blessed that we finally seen something working. But Maya relapsed.
Beata's explaining to the emergency room, this is what needs to be done.

Speaker 21 You don't understand how much medication it takes to control her pain.

Speaker 18 But they didn't listen.

Speaker 24 They accused Beada of medical child abuse.

Speaker 9 The audio you just heard is from the Netflix documentary, Take Care of Maya.

Speaker 26 People believe their eyes.

Speaker 12 That's something that actually is so central to this whole issue and to people that experience this, is that

Speaker 23 we do believe the people that we love when they're telling us something.

Speaker 31 I'm Andrea Dunlop.

Speaker 32 Welcome to season three of Nobody Should Believe

Speaker 36 If you'd like to support the show, you can subscribe on Apple Podcasts or on Patreon, where we release all episodes early and ad-free and have tons of bonus content.

Speaker 39 If monetary support is not an option, rating and reviewing really helps and sharing on social media or wherever you talk to people.

Speaker 5 We also have a couple of new ways to get in touch.

Speaker 41 I'm still very on Instagram, but you can also email us at hello at nobodyshouldbelieveme.com or you can leave us a a voice message at 484-798-0266.

Speaker 11 And all that information will be in the show notes.

Speaker 36 If you are just joining us, it will be very helpful if you go back and listen to season one and season two before diving in.

Speaker 41 It will give you a great foundation for the concepts of what we talk about on this show.

Speaker 32 This season, we are going to be diving into one of the things we get asked about the most, the concept of false allegations of medical child abuse.

Speaker 26 And we're starting with the biggest case in the headlines right now, the Maya Kowalski trial, and the Netflix documentary about this story, Take Care of Maya.

Speaker 51 You know, so what we covered in our first episode about this documentary was really what we felt had been omitted.

Speaker 45 There were these gaps in the story that you could tell from watching it, and we knew there was just so much more to this case.

Speaker 43 And as I've been digging through the documentation that's publicly available, I've found answers and context for some of those things that were left out.

Speaker 8 And I feel like those pieces of information are really important to our understanding of this case and how these cases play out and this whole concept about false accusations that's really catching fire right now.

Speaker 2 And as a reminder, because I see this kind of misdirection happening everywhere in the conversation about this case, Beata Kowalski is not on trial.

Speaker 19 The hospital is on trial.

Speaker 26 Kathy Beatty is on trial.

Speaker 38 DCF is on trial.

Speaker 14 Originally, Sally Smith and Suncoast were also on trial.

Speaker 26 They have settled that of court.

Speaker 39 I do not have details about what that settlement was or why it happened.

Speaker 56 If I get them, I will most certainly share them here.

Speaker 36 So, Jack Kowalski, the father of Maya Kowalski, is currently suing those parties for $220 million in punitive damages.

Speaker 12 So we are doing something that we have not yet done here on Nobody Should Believe Me, and that is covering a case that is happening in real time.

Speaker 43 So this is going to be different.

Speaker 53 We're going to have updates.

Speaker 39 The description of the Take Care of Maya documentary on the production company's website really tells you what you need to know about the angle that it's taking.

Speaker 27 My My producer Tina is going to read it for us.

Speaker 61 When nine-year-old Maya Kowalski was admitted to the Johns Hopkins All-Children's Hospital near Sarasota, Florida, her only problem was a painful stomachache.

Speaker 61 By the time she left the facility, three months later, her health had declined, her world was shattered, and her mother was dead.

Speaker 61 This true crime featured documentary unravels a medical horror story that is still playing out, one with the potential to uncover an overlooked national menace.

Speaker 61 Are a handful of medical professionals saving children like Maya from abusive homes, or are they running a for-profit scheme that destroys hundreds of families each year?

Speaker 62 If you watch this film without knowing anything else about this case, you would probably leave with the impression that Biata Kowalski was a mother who was falsely accused of medical child abuse and that those false allegations drove her to kill herself.

Speaker 14 The documentary also broadens the scope by the end to insinuate that there is a quote national menace of false accusations of medical child abuse happening in this country, and that any parent who takes their child to the doctor is at risk of having that child kidnapped.

Speaker 51 So for someone like me who works in this field, who has spent the last several years of my life very deep in these cases and these issues, this premise just could not be more wrong.

Speaker 19 The actual epidemic about medical child abuse in this country is one of underreporting.

Speaker 9 People who are committing this crime are not being held accountable by and large.

Speaker 28 That is what we know from all of the experts we have talked to.

Speaker 8 So let's start off by talking about what the concept of a false accusation would mean in a case that was at the stage that Biota Kowalski's case was when she died, which is halfway through a criminal investigation.

Speaker 50 It would mean that the doctors who reported their suspicions, the judge who made the no contact order, and the DCF officials who were working on the case all knew that Beada Kowalski was not actually abusing her child and they were holding her daughter and keeping them apart anyway.

Speaker 29 The plaintiff's strategy is clearly to fixate on Maya really had CRPS.

Speaker 3 And if she really had CRPS, that means Beata was innocent.

Speaker 32 That means she was falsely accused.

Speaker 35 That means this hospital is liable.

Speaker 6 It's a red herring.

Speaker 31 And

Speaker 23 this film, you know, really focuses on that.

Speaker 42 And they bring up this sort of smoking gun that the hospital was billing her insurance for treating CRPS.

Speaker 25 So the point I want to make is that the plaintiffs are leaning really hard on two things.

Speaker 12 Number one, that Maya genuinely had CRPS.

Speaker 19 They are leaning really hard on that.

Speaker 5 And the reason they're leaning really hard on it is because they are using a completely false description of factitious disorder imposed on another.

Speaker 39 And they misrepresent what's in the DSM.

Speaker 23 They say,

Speaker 48 oh, well, we had this Dr.

Speaker 63 Duncan evaluate her.

Speaker 31 And Dr.

Speaker 48 Duncan says in her report that if there's a genuine diagnosis that rules out Munchausen by proxy, fectious disorder imposed on another, it does not.

Speaker 15 That is false.

Speaker 25 So in this context, a false accusation would mean that you were making an accusation that you knew not to be true.

Speaker 31 not reporting a genuine suspicion of harm being done.

Speaker 38 And the reason I want to start this conversation by talking about what is and is not a false accusation is that this case and the the media coverage about it have implications that go far beyond just this family and this situation.

Speaker 4 And right now, in many places in the country, including a big situation in Lehigh, Pennsylvania, which we will talk about, child abuse pediatricians are under attack.

Speaker 14 They are getting pushed out of their jobs.

Speaker 64 They are getting excoriated in the press.

Speaker 43 And this has real consequences, both for those pediatricians and for the children that we trust them to protect.

Speaker 32 I spoke to friend of the show, Detective Mike Weber, who you will certainly recognize if you've listened to our previous seasons, about what impact this kind of media coverage has on doctors.

Speaker 68 It can cause doctors not to report. Doctors are human beings.
They're subject to the same types of pressure as all of us, right? And

Speaker 68 if they see

Speaker 68 societally that they could be vilified for this,

Speaker 68 the incentive to report is going to go away. And who's going to yell about that?

Speaker 69 Well, me, but

Speaker 19 if it comes to light, right?

Speaker 68 If they don't report it, it never comes to light. We never know.
And the child just continues being abused.

Speaker 2 Right. And I mean, I think it's not just doctors, right?

Speaker 59 It's doctors. It's

Speaker 38 DCF or CPS, you know, the child welfare organizations.

Speaker 3 It's the sheriff department. It's the police.
It's the DA.

Speaker 38 It's everyone that sees like, wow, this is how a case can play out.

Speaker 42 even if there is quite a lot of evidence, which we will talk through and which we have discovered there was.

Speaker 12 So, the important takeaway here is that doctors are required by law to report reasonable suspicions of abuse, not to come forward with evidence.

Speaker 12 And we also spoke to my dear friend B. Yorker, who is an incredible expert in Munchausen by Proxy and Medical Child Abuse.
She was a longtime psychiatric nurse and is a professor of law emerita.

Speaker 22 I'm a nurse. I am a mandated reporter.

Speaker 22 I am required to report suspected abuse. I am not required to verify abuse.
That's the job of CPS, Child Protective Services, or law enforcement.

Speaker 22 As a mandated reporter, I have immunity for reporting if it's done in good faith,

Speaker 22 if I happen to make an error and it wasn't abuse.

Speaker 22 On the other hand, to diagnose someone with a DSM-5

Speaker 22 or an ICD 10 or 11 diagnosis,

Speaker 22 I would need to be a physician, a psychiatrist, a PhD psychologist, or somebody within whose scope of practice it is to diagnose.

Speaker 22 As an advanced practice nurse, it's my scope of practice to do nursing diagnoses.

Speaker 22 Believe me, factitious disorder imposed on another is not in the book of nursing diagnoses. So I always say to the court, I am a mandated reporter.

Speaker 22 I am qualified to identify and to confirm because of my advanced practice training. I am qualified to confirm whether abuse has occurred to this child or neglect or sex abuse.

Speaker 22 That I am qualified to do. What I am not qualified to do is to diagnose why the perpetrator is doing it.
And so I defer.

Speaker 22 I say, yes, in this case, the child is being medically abused and over-medicalized, and the mother is fabricating and exaggerating,

Speaker 22 and it's up to somebody else, hopefully, who understands that the record review that I performed is the most illuminating for diagnosing factitious disorder imposed on another and looking for fabrication.

Speaker 22 But sometimes they need to determine, is it malingering? Is it anxiety? Is it delusion? Is it factitious disorder imposed on another?

Speaker 22 And FDIA

Speaker 22 should only be diagnosed when you both interview the suspected perpetrator and review the medical records for fabrications.

Speaker 50 Again, we've talked a little bit about how they framed Dr.

Speaker 3 Sally Smith's role in an incorrect way, but they made a big deal of the fact that Dr.

Speaker 9 Sally Sally Smith only spent 10 minutes talking to them.

Speaker 3 But it's not really, it's not her role to evaluate the child's health.

Speaker 66 It's her role to go back through the records, which I'm assuming were extremely voluminous, and look for these patterns of deception and these patterns of medical child abuse.

Speaker 2 So that is not something the fact that she spent, you know, they frame it as she spent. few minutes talking to this family and just made her mind up.
And that's not what happened.

Speaker 69 I mean, we can see that in the records that that's not what happened. She was still working on her report, even during, you know, this first part of the investigation.

Speaker 68 Right. And her report was a 45-page report.
So it was not, you know, it was not some small document. Right.
And it obviously was not put together haphazardly.

Speaker 68 One of the notes that the detective did make in her narrative that was extremely interesting to me was that an allergist had actually charted concerns for Munch Housing by proxy in Beata

Speaker 68 in December of 2015, 2015, a full eight months before this investigation kicked off. And that's another doctor having the same concerns.

Speaker 58 And there was another hospital that had reported her as well.

Speaker 2 There was a hospital that she had seen, there was a rehabilitation nurse that actually made a report.

Speaker 2 One doctor just put it in his notes, I believe, and then there was another doctor that actually called it in.

Speaker 3 And to be fair, they do mention this in the movie that she'd been reported by more than one place, but they rushed past it pretty fast and they don't really give any details on that.

Speaker 38 And to me, I mean, I think to me, one of the strongest indicators that something is amiss is if you have multiple people who have no communication with each other reporting concerns, right?

Speaker 8 That really points away from, oh, this is all at the feet of one overzealous doctor.

Speaker 68 I think it's also important to point out that, you know, a hospital like John Hopkins is a huge place.

Speaker 68 You're going going to have multiple people caring for this child that may not even know each other. Are we to believe that they're all in some big conspiracy?

Speaker 15 There is a very specific protocol when it comes to reporting in these cases. And I spoke to a pediatrician in Florida about this process.

Speaker 45 She opted to remain anonymous for this interview because of her proximity to this case.

Speaker 21 The physician makes the report to DCF or the social, whoever from the hospital makes the report. DCF takes the report.
There's a medical branch of DCF that gets involved.

Speaker 21 And then it's taken to the court. And that's kind of the process that happens.
And they do circle back around to the physicians for more information. They circle back for more notes.

Speaker 21 That's why documentation becomes so important. And then they use, the court uses that information to determine if the child is sheltered.

Speaker 21 So the physician does not make, neither does the social worker at the hospital. That call is not come from them.

Speaker 63 That call is made by a judge.

Speaker 13 Correct.

Speaker 63 Very important to know that this is not a call that is being made by the doctors, and it may be based on information given by the doctors, but I sort of always wonder why that's presented as suspicious because I think that's who should be making that call.

Speaker 63 That's who's in the position to make that call.

Speaker 59 The film presents Beata's behavior at the hospital as pushy.

Speaker 69 The defense attorney describes it as she offended someone over there.

Speaker 5 And here's that audio from the documentary.

Speaker 24 I think she could be

Speaker 24 a little too direct sometimes, and maybe some of the doctors took that offensively. I believe somebody at All Children's Hospital was offended and a conflict started.

Speaker 3 And they sort of say she was being very insistent.

Speaker 2 She was saying, I know my child, this is the treatment that works for her.

Speaker 40 And again, from the documentary.

Speaker 70 Her concern was merely administering ketamine.

Speaker 70 Over and over, more and more and more. She was belligerent, demanding.

Speaker 71 The mom was very controlling and she told me, this is what you are going to do. There are risks of respiratory failure, cardiac arrest.

Speaker 71 Her daughter could die from this and it didn't seem that she was, you know,

Speaker 71 worried about that.

Speaker 53 And again, we've talked about that a parent knows their child well and doctors will always listen to parents, but a parent does not have the right to go into a hospital and insist on a specific treatment, especially something as, you know, she was not asking them to give her Tylenol.

Speaker 9 She was asking them to put her in a coma and give her an infusion pump in her spine.

Speaker 2 So that was what Beata was insisting upon.

Speaker 2 And she made a number of comments about Maya's mortality while she was in the hospital that were not included in the film that to me, when I read them were just jaw-dropping.

Speaker 2 She said, things such as, Maya is in so much pain, she wants to go to heaven.

Speaker 9 And then when they were refusing to put her in a ketamine coma, she said, if you won't treat her with this here, I might as well seek out hospice so that I can get enough ketamine so that she can finally die.

Speaker 2 She doesn't want to live like this anymore.

Speaker 55 And these are things that she said in front of her daughter.

Speaker 57 So

Speaker 38 this is not the only time that Beata had talked about.

Speaker 2 Maya's mortality. Can you tell us about what came up in some of this other documentation that we saw about Beada framing this as a terminal illness.

Speaker 21 Beata was getting IV dilaudid, which is an opioid pain medication from Maya to be administered at home from Dr. Kirkpatrick.

Speaker 21 She asked the IV infusion company, which is the one where she worked, for terminal to be placed on the diagnosis for the medication.

Speaker 21 Again, I don't know if that's to get insurance to cover it or what the purpose was, but she asked for that. They actually reached out to Dr.

Speaker 21 Kirkpatrick, Kirkpatrick, who said that is out of his scope of practice to put terminal on the prescription.

Speaker 3 And also, I have to say, I was struck by the second half of that letter from Dr.

Speaker 62 Kirkpatrick, which told Beata to seek out resources from her local hospice care.

Speaker 21 Exactly. So he wasn't willing to say it, but then recommended that.
And then it still ended up somehow. from the company to be on that prescription.

Speaker 21 And then what it says is she went back to a second pharmacist within that company and said, can you put terminal on? They again reached out to Dr. Kirkpatrick, who said no.

Speaker 21 And it was not put on at that time by that pharmacist. So there was concern too, with, I believe, the company that she worked with then reaching out.
And it seemed Dr.

Speaker 21 Kirkpatrick, at least at that point, was not comfortable adding that word.

Speaker 33 We can't know for sure why Piata was making that request.

Speaker 64 We know that Maya was already receiving a very high dosage of ketamine.

Speaker 42 What could a reason possibly be that someone would add, like, what what is, what's the purpose of adding terminal to a prescription?

Speaker 69 Like, do the insurance companies treat it differently?

Speaker 9 Does that permit a higher dose?

Speaker 26 Does it permit more coverage?

Speaker 37 Like, what could some possible reasons be?

Speaker 21 I mean, my, my thoughts, at least from experience, would be that there are doses of pain medications you can use at home legally, because now there's a lot more restrictions as well

Speaker 21 in cases of palliative care, hospice care, versus just a child who may need pain medication.

Speaker 21 So dosage that would be appropriate to use in the home or even IV opioids in the home, in my experience, I mean, that is a very rare occurrence in and of itself,

Speaker 21 as well as the fact that insurance companies may question if there aren't certain terminology. You know, we're asked sometimes, oh, did you mean failure to thrive or did you mean malnutrition?

Speaker 21 Because there's a word that the company would say, oh, you just didn't use the correct terminology.

Speaker 21 And that terminology may be correct in that case, but asking you to put something on a prescription that is not correct, at least in your medical opinion, is an interesting piece, especially something that involves the word terminal is just strange.

Speaker 29 Yes, it is strange.

Speaker 7 Now, eventually, Beada was successful in getting terminal added to Maya's prescription.

Speaker 45 And in the testimony that was recently released, Pharmacist John Schott, who filled this prescription, testified that he only added the terminal designation after a 10-minute conversation with Dr.

Speaker 35 Kirkpatrick.

Speaker 15 They questioned Dr.

Speaker 26 Kirkpatrick about this as well, and he repeated his stance that this was out of scope of his practice to label her as terminal and that he did not recall having this conversation with Shot.

Speaker 53 Now, this testimony is happening years after the fact.

Speaker 35 There are several possibilities.

Speaker 39 It could have been a genuine miscommunication.

Speaker 45 He could easily not remember a conversation he had many years ago.

Speaker 6 That's perfectly credible.

Speaker 5 But it does raise questions as to how this label got on there.

Speaker 66 There were a lot of things that Dr.

Speaker 29 Kirkpatrick said in the documentary that

Speaker 10 came off very strange.

Speaker 54 Here's a clip from the documentary of him talking about a message that he sent to Beata while Maya was at Johns Hopkins.

Speaker 20 This was not the first time I've seen this type of scenario.

Speaker 20 After a few days at the hospital, they refused to give her ketamine.

Speaker 20 And without the high-dose ketamine treatment, she had virtually no mobility in her legs at all.

Speaker 20 And that's where you get these blood clots forming, which can break off, go to the lungs, and it could be fatal.

Speaker 20 And I felt it was important that Beata understood the seriousness of this.

Speaker 20 So I warned her, in all medical probability, that Maya would die a slow, painful death.

Speaker 30 The whole timeline of Dr.

Speaker 45 Kirkpatrick's treatment with Maya is very

Speaker 21 striking.

Speaker 14 So, this is a child who has her alleged onset of these symptoms in July of 2015.

Speaker 10 And her first meeting with Dr.

Speaker 14 Kirkpatrick, where she officially gets diagnosed by him with CRPS, is just a few months later in September of 2015.

Speaker 34 And by that fall, she had already escalated to doing these four-day ketamine infusions. And Dr.

Speaker 14 Kirkpatrick had sent them down to see Dr.

Speaker 51 Cantu in Mexico who performed the five-day ketamine coma procedure.

Speaker 60 This is the procedure that notably has a 50% chance of death. And this for me,

Speaker 40 I just don't understand how a reasonable person can look at this series of events and not have questions.

Speaker 56 How do you go from the onset of a pain disorder in July to giving your child a treatment for that pain that has a 50% chance of death.

Speaker 46 And this is the treatment that Beata was demanding at Johns Hopkins, not just that they give her ketamine, that they give her an infusion pump and put her in a coma.

Speaker 42 So I had lots of questions about Dr.

Speaker 35 Kirkpatrick.

Speaker 36 And in fact, another piece of his testimony was just released into the public record.

Speaker 32 This one is from 2022.

Speaker 35 So with the caveat, of course, that I am not a doctor, in going through Dr. Kirkpatrick's testimony, there were some pretty notable things.

Speaker 45 And I think it's important to have this information to give some context for what he says in the documentary.

Speaker 32 Number one, the language that they are always using to describe Dr.

Speaker 26 Kirkpatrick.

Speaker 48 Dr.

Speaker 53 Kirkpatrick is not board certified in either pediatrics or neurology.

Speaker 14 He is an expert in the treatment of CRPS using ketamine.

Speaker 36 His background is as an anesthesiologist and he runs a pain clinic where it appears from his website and all the information I could find there that the main thing he does is treat pain disorders with ketamine.

Speaker 15 This is also the subject of his research.

Speaker 27 So it actually makes sense that he has a background as an anesthesiologist because this is one of the main things that ketamine is used for here in the U.S.

Speaker 56 Importantly, also in the film, he's very critical of Dr.

Speaker 12 Sally Smith for not including notes on the phone call that they had in October of 2016 in her report.

Speaker 45 So, another important piece of information that comes from his testimony is that Dr.

Speaker 60 Kirkpatrick, by his own admission, is doing pro bono work on behalf of the Kowalskis.

Speaker 45 He says this in his testimony: that he created a quote roadmap of what he believed happened in this case, and he provided this roadmap to the producers at Netflix.

Speaker 46 There are a few other things that struck me about Dr.

Speaker 60 Kirkpatrick, both in his testimony and sort of the way he speaks in the film.

Speaker 8 He uses really hyperbolic language.

Speaker 53 He refers in his testimony to Maya being incarcerated at Johns Hopkins.

Speaker 58 That is really notable language for a doctor to use about one of the most highly respected medical institutions in the country.

Speaker 40 That is notable.

Speaker 48 And I just have to say,

Speaker 2 there is a moment where he nods off during his testimony.

Speaker 43 That doesn't necessarily tell us anything about his testimony.

Speaker 2 I just wanted to include it.

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Speaker 42 So Dr.

Speaker 45 Kirkpatrick does not have any training in child abuse pediatrics and he has never worked in child abuse prevention.

Speaker 46 And I know this because the lawyers asked him these specific questions.

Speaker 34 So as we mentioned, he only saw Maya in his office a few times.

Speaker 51 He was not treating her for a long period of time.

Speaker 44 His relationship with her only goes back a year before the Johns Hopkins hospitalization.

Speaker 53 And as we've discussed, he does not have any experience or certification in pediatrics.

Speaker 38 So the reason that Dr.

Speaker 39 Kirkpatrick only saw Maya a few times is that none of the treatments that he offers at his clinic are covered by insurance.

Speaker 14 He claims in his testimony that that's because his surgery center is a nonprofit.

Speaker 2 It is not in and of itself a nonprofit.

Speaker 45 He does have a research institute that appears from what I could find to fund research done solely by him.

Speaker 51 This research institute is a 501c3, but his surgery center, in fact, is a cash-only practice.

Speaker 9 This is all information that's available on Dr.

Speaker 14 Kirkpatrick's website and in the filings for his 501c3.

Speaker 49 I did reach out to his surgery center and his team for comment and they did not respond.

Speaker 38 So this was the reason that the Kowalskis started going to Dr.

Speaker 49 Hanna.

Speaker 26 And we will talk more about Dr.

Speaker 55 Hanna in an upcoming episode.

Speaker 15 So when it comes to Dr.

Speaker 42 Kirkpatrick, there are two possibilities here.

Speaker 51 One is that Beata was genuinely on a search to help her daughter and that she discovered this one doctor and he gave her this advice to pursue these high-dose ketamine treatments and to pursue putting her daughter in a ketamine coma.

Speaker 46 And she was desperate to help her daughter and she followed that advice.

Speaker 15 There is another possibility.

Speaker 51 The other possibility is that she was looking for someone to give her the most extreme treatment possible

Speaker 34 because that is something that offenders do in these cases. This is something we talked to Dr.

Speaker 26 Carol Jenny about.

Speaker 73 There are outlying doctors that just suck up these cases. You know, there are cowboys out there who just have odd

Speaker 73 beliefs that, oh, yes, everybody they see has POTS disease or everybody they see has chronic Lyme or whatever.

Speaker 73 And they come up with these diagnoses and literally they do very well diagnosing these oddball diseases, which probably exist in a small number of people, but everybody they see has that disease.

Speaker 27 And one would imagine that medical child abuse is overrepresented.

Speaker 68 Oh yes.

Speaker 73 Oh yes.

Speaker 55 They just flock to the there's a problem in the medical care community too.

Speaker 73 There's doctors who who make the same diagnosis over and over and over and the mothers get online and they say, oh, everybody that he sees has mesenteric artery syndrome.

Speaker 73 And that if you go there, you'll get surgery for that. Now, what happens most of the time is that doesn't cure the pain, strangely enough, but they still go and they still get their surgery.

Speaker 7 Well, and if the pain never existed to begin with.

Speaker 55 Exactly.

Speaker 73 Or the pain is totally unrelated.

Speaker 45 I just wanted to interject here that in this conversation, Dr.

Speaker 31 Carol Jenny and I are talking about generalities.

Speaker 33 And we do not know if this is what was happening with Maya, but we need to hold that as a possibility rather than coming to the conclusion that it wasn't.

Speaker 73 The other problem is that once these kids get to be a certain age, they're very much part of the problem.

Speaker 73 They're very much trained to be in constant pain, in constant distress, unable to eat, whatever. And then, you know, then it's a real hard problem because

Speaker 73 to turn that around is really an issue.

Speaker 50 Yeah, I've done some work with survivors and I'm close with a few of them and they've talked about that, that they have these memories of being, you know, once they got to be 10, 11, 12, of

Speaker 2 not understanding

Speaker 58 even their own bodies, of just sort of really being so disconnected and understanding that like their mother was wanting them to say these things, to perform these things, to report these things to the doctor.

Speaker 63 And then also just not even sometimes just being, you know, being very convinced themselves that they were sick, even once they've discovered that they were victims, being very afraid to try sports or, you know, do any number of things because they've just been so convinced that they're ill and the world is this incredibly dangerous place for them because they're so fragile.

Speaker 63 Yep.

Speaker 9 We are working on finding an expert in CRPS to talk directly about this and ask them some questions.

Speaker 7 Frankly, there are not that many of them and certainly every single one of them in the country right now is familiar with this case.

Speaker 43 So, we have put in some calls to the Mayo Clinic, some pain specialists here in Seattle, and the University of Washington.

Speaker 10 So, we are working on getting someone to talk to.

Speaker 2 But, importantly, as Dr.

Speaker 31 Kirkpatrick says himself in his testimony, there are no lab tests or electronic imaging tests or anything like that that you can use to diagnose CRPS.

Speaker 32 Like many things, CRPS is something that is diagnosed by observation and report using something called the Budapest criteria, which is a checklist.

Speaker 57 So

Speaker 66 one last thing to say about Dr.

Speaker 17 Kirkpatrick.

Speaker 32 Something I found really interesting reading through this documentation was the story of how Beata found out about Dr.

Speaker 34 Kirkpatrick.

Speaker 37 In the movie, Jack Kowalski describes the series of events where Maya has an asthma attack and then starts suffering from debilitating pain.

Speaker 45 And Beata stays up all night researching, and that's how she finds Dr.

Speaker 17 Kirkpatrick.

Speaker 8 But this isn't quite how it happened.

Speaker 66 Here's that clip from the documentary.

Speaker 18 We knew as parents, something was wrong, and they are not doing enough.

Speaker 18 So when Beada got home, she didn't go to bed. She researched.

Speaker 18 And that's when she ended up finding Dr. Kirkpatrick.

Speaker 48 In the psychiatric evaluation that a Dr.

Speaker 11 Duncan did of Beata Kowalski, she talks to a number of her friends.

Speaker 46 They're sort of character witnesses or just just people to tell her a little bit more about Beada and her life.

Speaker 34 The documentary does mention Dr.

Speaker 46 Duncan's psychiatric eval because at the end of it, Dr.

Speaker 11 Duncan says that if Maya legitimately has CRPS, Munchausen by proxy can be ruled out.

Speaker 14 Now, as we've addressed elsewhere, this is not true.

Speaker 58 The film doesn't make any mention of what's in the rest of this evaluation, and it was something elsewhere that caught my eye.

Speaker 11 This is from an interaction with a friend that the evaluator spoke to named Jessica Stevens.

Speaker 27 My producer Tina is going to read it for us.

Speaker 61 I first came to know of the Kowalski family in August 2015.

Speaker 61 My father suffers from Crohn's disease and requires intravenous nutrition and other infusions to keep him alive. Beata was assigned to his case as his infusion nurse.

Speaker 61 One day, my father overheard Beada on the phone talking about her ill daughter who was in the hospital at the time.

Speaker 61 When she hung up, he asked her about it and she explained how her once healthy nine-year-old daughter had deteriorated over the past several months after suffering from life-threatening asthma attacks to the point that she was now unable to sit up or walk.

Speaker 61 Worse than that, she was in constant agonizing pain that was hard to control and getting worse as time progressed instead of getting better.

Speaker 61 Listening to her, my father sympathized, having gone through a similar struggle with me, and suggested she consult with Dr. Anthony Kirkpatrick in Tampa.

Speaker 61 He has over 30 years of experience in treating difficult pain cases and has been instrumental in orchestrating my care and treatment several years earlier. Maya was ultimately seen by Dr.

Speaker 61 Kirkpatrick and diagnosed with RSD CRPS. She was scheduled to receive a round of ketamine confusions at his treatment center.

Speaker 12 There's more to say about this asthma diagnosis and we will get to that a little bit later. But what struck me, again in the context of possible doctor shopping, is that again, maybe she found Dr.

Speaker 12 Kirkpatrick because she was at the end of her rope. But again, considering the timeline, it's also possible that this is where she got the idea.

Speaker 12 Also, because of the timeline here, because she said they met in August 2015, this is about a month after the alleged onset of the CRPS.

Speaker 12 So when she says her doctor's in the hospital, she is almost certainly talking about this Tampa general hospitalization, which was one of the other times that Beata got reported to CPS.

Speaker 12 One of the other things that really struck me actually in Dr.

Speaker 12 Kirkpatrick's testimony is that he mentions that on one of the several times that he saw Maya when she visited his office shortly before she went down to Mexico to have her ketamine coma, that he was concerned about her and had recommended that Beata take her to a doctor because she was

Speaker 12 very dehydrated. There was another moment in Dr.
Kirkpatrick's testimony that was recently released that caught my eye.

Speaker 12 The lawyer who is cross-examining him is asking about what Maya's reaction was to the ketamine infusions that he started to administer in October of 2015. And

Speaker 12 he asked if After your infusions in October of 2015, did you come to believe the disease was permanent? And Dr.

Speaker 12 Kirkpatrick says, after the infusions, I don't think I documented that, but we do know that after the infusions, she'd get a little bit better, but much less than what I would expect.

Speaker 12 And approximately 13 days or so later, she came in in trouble. She was dehydrated.
She was not taking her medicine. She was not sleeping.
She's not eating, and she was deteriorating.

Speaker 12 It became a very serious situation at that point.

Speaker 12 So this strikes me for two reasons. Number one, in the film by his own.
admission, Dr. Kirkpatrick is extremely insistent about her getting these ketamine infusions.

Speaker 12 Now, whether or not he was advocating for her to be put in a ketamine coma, which is actually what Beada was requesting at Johns Hopkins, I don't know.

Speaker 12 Presumably he wasn't because he knows that that's not legal in the U.S. So presumably he was not insisting on that, but he was insisting that she needed this high-dose ketamine treatment.

Speaker 12 And yet here, by his own record, she was deteriorating after getting these treatments.

Speaker 12 The other thing that struck me about this piece is that he mentions, you know, she's not eating well, she's not taking her medication, she was dehydrated.

Speaker 12 She came into Johns Hopkins in a similar state. They brought her in for stomach pain.
And one of the things in the notes is that she reported that she hadn't been allowed to eat anything in five days.

Speaker 12 So again,

Speaker 12 there may be some other medical explanation for why she wasn't eating on both of these occasions. But as of right now, we don't have one.
So that's a curious thing.

Speaker 12 And also, these things around food and eating are a huge part of these cases, as we know. So one of the the other recently released pieces of testimony is from Dr.

Speaker 12 Cantu, who is the doctor in Monterey that actually did the procedure, the five-day ketamine coma with Maya. A couple of things stuck out to me.

Speaker 1 So one of the questions that they asked Dr.

Speaker 12 Cantu was whether or not all other treatments should be administered before doing something as extreme as a ketamine coma. And he says basically, yes, yes, they should.

Speaker 12 All of their modalities of treatment should be tried before this.

Speaker 12 And also that for people who are getting this procedure, it should be generalized in their body, basically covering at least 80 or 90% of their body.

Speaker 12 So this is people who are having just full body CRPS, which is, again, extremely rare, but is something that's known to happen.

Speaker 12 And we see even in a lot of the video presented in the documentary that she's confined to a wheelchair. It's allegedly really affecting her lower extremities.

Speaker 12 So this question of the full body CRPS just seems a little hazy.

Speaker 12 The other thing I think that really stuck out, you know, when he's describing the actual setup for the procedure, you know, they talk about inserting a tube into the trachea and all of these invasive monitors and an aerial line and a PIC line that they have to put in because the patient is being put in a coma and so their airway can be obstructed.

Speaker 12 And they talk about how this has a risk of death and how that was discussed in front of the patient. He also talks about how Maya is the youngest patient he's ever done this procedure on.

Speaker 12 And one of the lawyers asks him, Did you tell this family that the risk of death was 50%? And his answer was 50% or more. This had a 50% or more risk of death.

Speaker 12 So we are recording this on Monday, September 11th and the pretrial hearings for the lawsuit case where Jack Kowalski is suing Johns Hopkins, Kathy Beatty, and DCF for $220 million.

Speaker 12 Those pretrial hearings just started today. Jury selection will happen later this week.

Speaker 12 And just as a note, of course, we will give you the major updates here on the main feed, but I'm also going to be doing weekly coverage on my Patreon and Apple subscriber feeds about what is going on on a weekly basis in the trial.

Speaker 12 And all of those links, as always, can be found in our show notes.

Speaker 12 And we are doing this season as we go. So if you have questions about this case, if you have thoughts about this case, please reach out to us.
I'm always available on Instagram. I'm at Andrea Dunlop.

Speaker 12 And in the next episode, we are going to take a deep dive with Detective Mike into the police report about Biata Kowalski and the transcript of the interview between the detective and Jack Kowalski.

Speaker 12 That's next time on Nobody Should Believe Me.

Speaker 14 Nobody Should Believe Me is a production of large media.

Speaker 32 Our senior producer is Tina Knoll and our editor is Corrine Kiltow.

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