Like every day for the past week, Justina Pelletier’s family rolled her into court Monday morning in a wheelchair. Her nails had a fresh coat of lavender polish, and a fuzzy gray blanket lay over her legs.
Now 21 years old, Pelletier took the stand in the malpractice suit she and her family are bringing against Boston Children’s Hospital and the doctors who treated her there.
As she described the nine months she was in the hospital’s locked psychiatric ward, Pelletier began to sob. Watching her from the courtroom’s front row and waiting for her own turn at the stand was Dr. Colleen Ryan, the psychiatrist who was in charge of Pelletier’s care during that time.
Pelletier first arrived at Boston Children’s Hospital at 4 a.m. on Feb. 10, 2013, with severe stomach pain and dehydration. On a scale of one to 10, Pelletier said the pain was at a seven. Four days later, she said, she was making Valentine’s Day cookies with her mother when several guards in black uniforms swept her away.
“All of a sudden, I just didn’t see her. She wasn’t there,” Pelletier said.
“Did you get a chance to say goodbye?” John Martin, Pelletier’s lawyer, asked her.
“No,” she said.
The doctors on Pelletier’s care team believed her symptoms were largely psychological, rather than due to a rare genetic condition called mitochondrial disease, as her parents believed. The illness affects how cells create energy. Instead, the doctors suspected Pelletier’s parents of abuse that might be causing some of her symptoms. So later that day, they moved her to the hospital’s locked psychiatric ward.
“All of a sudden, they said, 'You are going to go up there,' and I didn’t know why,” Pelletier said at the trial. “I didn’t want to. I just kept saying I wanted to go home.”
Once Pelletier was in the psychiatric ward, she said the doctors began limiting her contact with her family to an hour of visitation and 20 minutes of phone calls per week. She said her mother wasn’t allowed to ask her about her treatment or even how she was doing.
“I was able to talk to them for a little bit but someone was listening. If [my parents] said something about how I was feeling, they would stop it. Hang up,” Pelletier said, her voice wavering. “It was really hard to be away from my family.”
Pelletier said the medical staff was cruel to her at times during her stay in the psychiatric ward. She told her lawyer they would leave her on the toilet when she couldn’t defecate or in her wheelchair for intolerable periods of time.
“They didn’t believe [my pain], and they hurt me so much,” Pelletier said. “I kept getting weaker.”
Boston Children's Hospital doctor Colleen Ryan insisted she and other medical staff were doing what was best for Pelletier. She testified that Pelletier’s parents would obsess over her medical problems in a way that would make her worse. Ryan told jurors that’s why she recommended that the hospital and Department of Children and Families, which had taken custody of Pelletier, limit the contact between the girl and her parents.
“We had Justina’s best interests in mind, and we knew if there was less focus on negative aspects of her health and more on her positive experiences, then that would be beneficial to her health,” Ryan said.
“Don’t you think it’s reasonable for a mother to ask her daughter, 'Hey, how are you feeling? Has someone taken care of that dandruff yet?' ” Martin asked Ryan during the trial.
“Of course, as a mother, I understand that,” Ryan replied. “But to point out and insist on those things – we did not think that was good for her.”
In earlier statements, one of Ryan’s lawyers said that Boston Children’s Hospital doctors had learned that Pelletier seemed to do better when her parents were not present. In her testimony, Ryan said the parents often became belligerent during meetings, which added to suspicions that her parents might have actually been causing some of Pelletier’s symptoms.
“We were having a family meeting with [Department of Children and Families] and the parents – there was some very inappropriate and improper conduct going on,” she said. “It was very concerning.”
Ryan said she and her team tried repeatedly to engage the parents in Pelletier’s treatment, but she claims they were simply too combative.
“We always tried to involve the family,” she said. “We never got past the contentiousness. We tried so many times.”
Pelletier is now back with her parents and receiving treatment for mitochondrial disease from a doctor in Connecticut. She described how she’s improved in recent years through art therapy and physical activity. Her lawyer showed the jury drawings that Pelletier created in recent years – realistic animals drawn in color and black and white.
And in a recent video introduced by the defense, Pelletier is riding a horse named Sandman – one of her favorites – during a competition. She kicks the horse into a trot and then eases him back into a walk.
“You’ve gotten very good,” Cohen said, pointing to a photo with blue ribbons for riding competitions stuck to Pelletier’s chest.
“Thank you,” she said.