THE SECOND WITNESS called by the county was Dr. Wilson, the physician for the Fellows family.
He was a general practitioner in the Delphi area and had been for fourteen years, he testified. He had treated Joe Fellows, Mary Sue Fellows, and of course Joshua.
The doctor listed the symptoms for Joshua—some developmental delays, listlessness, low-grade fever, problems eating, nausea, loss of appetite. He admitted that such symptoms were not entirely uncommon—the point was to diagnose and treat them, he emphasized.
“Are those symptoms consistent with certain kinds of poisoning?” Putnam asked.
“All except the developmental delays—that symptom not so much, unless the poisoning was done incrementally, over a long period of time.”
“Did you prescribe a series of tests?”
“Yes.”
“Blood tests?”
“Yes. At one point we had Joshua admitted to the Delphi hospital as an outpatient to do some tests. Blood tests.”
“Did you recommend to Mary Sue Fellows some other tests?”
“Yes. I wanted to do a moderately invasive gastrointestinal procedure to rule out some differential diagnoses…”
“Did you have a specialist who was going to do that?”
“Yes,” Dr. Wilson replied, “but it did not happen.”
“Why not?”
“Mary Sue refused to permit it.”
“Did you consider talking to her husband to convince him—or even seeking a court order?”
“At the time, no. In retrospect, I wish I had come to you people sooner.”
“What reason did Mary Sue give for her refusal?”
“She said she didn’t think I knew what I was doing. She was fearful of complications for Joshua, and the painfulness of the procedure. And she didn’t think it was gastrointestinal.”
“Did she say anything else?”
“Yes—something that really bothered me.”
“What was that?”
“She said—and I recall this very well—Mary Sue said she was ‘giving Joshua to God.’ That’s exactly what she said.”
“Do you know what she meant by that?”
“Objection—speculation!” Will rapped out.
The judge overruled the objection.
“I was afraid that she might have made a decision—a very frightening decision—that somehow Joshua would be better off in heaven with God.”
“Is that when you called the Department of Social Services?”
“That’s what I did, yes.”
Putnam concluded his direct examination and sat down with a satisfied smile.
As Will began his examination, he walked to the lectern and opened a large notebook of medical records in front of him.
“The symptoms you noted for Joshua—you mentioned them for Mr. Putnam. Do you recall them?”
“Yes, I do,” the doctor responded.
“All of them—taken together as one constellation of physical symptoms—would be consistent with a medical condition known as methylmalonic acidemia, is that correct?”
“Actually, I’ve never treated any child with that condition. It’s rather rare.”
“Exactly. You were not looking for that condition, right?”
“It was not the first thing on my radar screen, diagnostically, that’s right.”
“But you must have read the medical literature about that condition? Let’s call it by its first letters for short—MA.”
“I had read—once, I believe—something about methylmalonic acidemia. But remember, Mr. Chambers, I am board-certified in family medicine—not in the more esoteric diseases. That is for the specialists.”
“So—do you agree that Joshua’s symptoms were consistent with MA?”
After a moment, Dr. Wilson nodded in agreement.
“Yes, to the extent I understand that particular medical condition.”
“Now. Mary Sue’s comment about God—did you take it literally?”
“I’m not sure I understand…”
“Well, a few seconds ago you used the phrase ‘on my radar screen,’ did you not?”
“Yes. A figure of speech.”
“Right. Exactly,” Will said. “But you really don’t have a radar screen in your office, do you?”
“Of course not,” Dr. Wilson said, turning to the bench for some relief from what he considered an absurd line of questioning, but finding none.
Judge Trainer continued sitting expressionless.
“So why,” Will continued, “didn’t you simply interpret Mary Sue’s comments about ‘giving Joshua to God’ in the same way? In other words, that she was committing Joshua’s medical problems to God through prayer, in addition to the medical care she was seeking? Why, instead, did you insist on believing she might kill her own son? Did you really think she would put him on a stone altar and sacrifice him to God?”
Bender jumped up first this time, with Putnam coming in second.
“Argumentative! Compound question also! We object to this—”
Judge Trainer motioned for them to sit down.
“The question does have some problems, Mr. Chambers. But I see where you’re heading. Doctor—why did you take Mary Sue so literally?”
“You really had to be there, Your Honor. This woman had refused the GI procedure I wanted to have done, she was hostile toward me, and the look in her eyes when she said it all—it really sent chills down my spine.”
The judge nodded for Will to continue.
“The look in her eyes? You invoked the police power of the County of Juda upon the life and domestic tranquility of this family because of the look in her eyes?”
“It was not just that…”
“But it included that. You just said that.”
“Yes, her look, her presentation of herself, everything.”
“But there was something else, wasn’t there?” Will followed quietly.
“I don’t know what you mean.”
“There was another reason you called Social Services down on this family, is that not correct?”
“I’m still baffled, sir, by your question,” the doctor responded, now shifting a little in the witness chair, but being careful to hold himself upright, shoulders back.
“Is it a fact that you called Social Services because you did not want to be sued for medical malpractice—again—for another child-abuse case?”
“Absolutely not! And I deeply resent that insinuation. I was not sued for malpractice for a child-abuse case.”
“Oh, is that true?”
“Yes. I was not sued.”
Will pulled some papers out of his file.
“Would it refresh your memory to review the Civil Complaint filed in The Estate of T.O., A Deceased Minor Child, By His Guardian, Versus The Delphi Family Clinic, And Dr. Ruttaluse, And Dr. Wilson?”
“I’m familiar with that lawsuit, but I need to explain…”
“The fact is that your partner, Dr. Ruttaluse, was the treating doctor for a child brought in repeatedly with bruises and injuries, who was finally killed by the live-in boyfriend of the mother. And it hit the news—and your clinic, including you as partner, were sued. Correct?”
Putnam objected wildly, but since Bender was talking and waving her arms at the same time, pointing to Will, the only words that could be deciphered in the melee were “outrageous” and “admonish.”
Judge Trainer ruled quickly and decisively.
“We are not going to rehash that Estate of T.O. case—I am well aware of it. And I am sure Dr. Wilson is too. Doctor, please answer the question.”
“Yes—a child treated by Dr. Ruttaluse was killed. It was child abuse—our clinic was sued—and I was named in that suit merely as a technicality.”
“And so you vowed that you—and your clinic—would not be involved in another debacle like that again. So you figured you would always err on the side of calling Social Services—and whenever you had the least problem with the parent of a pediatric patient, you would always just throw the ball to Social Services. Am I right?”
“I don’t like the term ‘throw the ball…’”
“How about ‘throw the parent’? You tossed Mary Sue Fellows to the Department of Social Services because of your concern over malpractice suits—and your malpractice-insurance premiums?”
“I referred Mary Sue Fellows over to Social Services. I don’t appreciate being sued, Mr. Chambers. No doctor does. It is a sad fact that we have to practice defensive medicine occasionally.”
“You were practicing defensive medicine with Joshua, then?”
Dr. Wilson lowered his gaze toward the medical file that lay in his lap. And then he answered.
“I did what I had to do…”
“As did Mary Sue,” Will concluded.