Revisiting Season 3: Shelter
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Hello, it's Andrea. First of all, thank you so much for all of the great feedback that you've sent us on our new in-between series format, Case Files. We got so, so many interesting responses about our Justina Pelletier mini-series, and in fact, we're going to be following up on a few of those in upcoming episodes, so keep an eye out for that.

I am really loving having these episodes to feature all of the many interesting things that end up in our inbox. You know, when I started this show, it seemed like the topic I was covering might be a bit niche, but it turns out there is just kind of endless stuff to talk about within the Nobody Should Believe Me extended universe. And I am so grateful to be able to keep doing this every week. And it's all thanks to you.

So today we are re-airing the first episode of season three, in which we covered the Kowalski v. Johns Hopkins all children's case, aka the story featured in the Netflix film Take Care of Maya.

I still think about this case all the time because it is just a perfect example of how damaging unscrupulous media coverage in child abuse cases can really be. And also because the outcome of this case could set a massive precedent for future parents' rights cases. And this is only going to become a bigger issue in this country given the recent political shifts.

So the Kowalski saga is very much ongoing as this verdict has been appealed. And there is a lot of drama going on behind the scenes with the legal team for the plaintiff. And we will continue to update you on all of that on the main feed at some point. Our third season of the show is really unique because I covered this case as it was unfolding in real time. And we have, at last count, more than 20 episodes about the Kowalski case on the main feed. And this is in addition to true

truly innumerable hours of bonus content on the Patreon, where I did weekly trial recaps with Dr. Becks and have been covering all of the developments of the appeal. A fun thing about this episode is that this case is Dr. Becks' origin story here on Nobody Should Believe Me. She started talking to us in this very first episode as our secret Florida doctor friend.

And as those of you who are subscribers will know, Dr. Bex now co-hosts our twice monthly subscriber show, Nobody Should Believe Me After Dark.

And speaking of subscribing, that is one of the very best ways that you can support everything that we are doing over here. You can subscribe on Apple Podcasts or on Patreon. And on the latter platform, we have a free tier where I unlock episodes for free listening from time to time. So for a limited time, I'm going to make all of our Kowalski content free to listen to over there. So if you want to join Dr. Bex and I on an absolutely obsessive deep dive about this case, you can go do that right now.

We will be back next week with a new episode to keep you company on your Thanksgiving travels. And our new full season is coming at you the first week of January. Now on with the show.

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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 MunchausenSupport.com to connect with professionals who can help. Every investigation begins with a question, but this film starts off with an answer. We as parents tried to do the best we can for our children.

But there's nothing that could prepare me for what I went through. Nothing. Beata and I had a beautiful family. But then Maya started to get sick. Maya had advanced complex regional pain syndrome, and we know what the best therapy is for it. It's called ketamine. We're just blessed that we've finally seen something working.

The audio you just heard is from the Netflix documentary, Take Care of Maya. 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 are just joining us, it will be very helpful if you go back and listen to season one and season two before diving in. It will give you a great foundation for the concepts of what we talk about on this show. 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.

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. You know, so what we covered in our first episode about this documentary was really what we felt had been omitted. 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. And as I've been digging through the documentation that's publicly available, I've been able

I've found answers and context for some of those things that were left out. 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.

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.

The hospital is on trial. Kathy Beatty is on trial. DCF is on trial. Originally, Sally Smith and Suncoast were also on trial. They have settled out of court. I do not have details about what that settlement was or why it happened. If I get them, I will most certainly share them here. So Jack Kowalski...

The father of Maya Kowalski is currently suing those parties for $220 million in punitive damages. 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. So this is going to be different. We're going to have updates.

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

When nine-year-old Maya Kowalski was admitted to the John Hopkins All Children's Hospital near Sarasota, Florida, her only problem was a painful stomach ache. By the time she left the facility three months later, her health had declined, her world was shattered, and her mother was dead. This true crime feature documentary unravels a medical horror story that is still playing out.

one with the potential to uncover an overlooked national menace. 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? If you watch this film without knowing anything else about this case, you would probably leave with the impression that Beata Kowalski was a mother who was falsely accused of medical child abuse and that those false allegations drove her to kill herself.

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

People who are committing this crime are not being held accountable by and large. That is what we know from all of the experts we have talked to. 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 Beata Kowalski's case was when she died, which is halfway through a criminal investigation.

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 Beata Kowalski was not actually abusing her child and they were holding her daughter and keeping them apart anyway. The plaintiff's strategy is clearly to fixate on Maya really had CRPS.

And if she really had CRPS, that means Beata was innocent. That means she was falsely accused. That means this hospital is liable. It's a red herring. And this film, you know, really focuses on that.

And they bring up this sort of smoking gun that the hospital was billing her insurance for treating CRPS. So the point I want to make is that the plaintiffs are leaning really hard on two things. Number one, that Maya genuinely had CRPS. They are leaning really hard on that. And the reason they're leaning really hard on it is because they are using a completely false evidence.

description of factitious disorder imposed on another. And they misrepresent what's in the DSM. They say, oh, well, we had this Dr. Duncan evaluate her. And Dr. Duncan says in her report that if there's a genuine diagnosis that rules out Munchausen by proxy, factitious disorder imposed on another, it does not.

That is false. So in this context, a false accusation would mean that you are making an accusation that you knew not to be true, not reporting a genuine suspicion of harm being done. 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 media coverage about it have implications across

that go far beyond just this family and this situation. 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. They are getting pushed out of their jobs. They are getting excoriated in the press. And this has real consequences, both for those pediatricians and for the children that we trust them to protect.

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. 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 if they see, you know, societally that they could be vilified for this, the incentive to report is going to go away.

And who's going to yell about that? Well, me, but only us. If it comes to light, right? If they don't report it, it never comes to light. We never know. And the child just continues being abused. Right. And I mean, I think it's not just doctors, right? It's doctors. It's

DCF or CPS, you know, the child welfare organizations, it's the sheriff department, it's the police, it's the DA, it's everyone that sees like, wow, this is how a case can play out. Even if there is quite a lot of evidence, which we will talk through and which we have discovered there was. So the important takeaway here is that doctors are required by law to report reasonable suspicions of abuse, not to come forward with evidence.

And we also spoke to my dear friend Bea 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 at Merita. I'm a nurse. I am a mandated reporter. 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.

As a mandated reporter, I have immunity for reporting if it's done in good faith, if I happen to make an error and it wasn't abuse. On the other hand, to diagnose someone with a DSM-5 or an ICD-10 or 11 diagnosis, I would need to be

physician, a psychiatrist, a PhD psychologist, or somebody within whose scope of practice it is to diagnose. As an advanced practice nurse, it's my scope of practice to do nursing diagnoses. But 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. 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. 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. I say, yes, in this case, the child is being medically abused and over-medicalized and the mother is fabricating and exaggerating

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. But sometimes they need to determine, is it malingering? Is it anxiety? Is it delusion? Is it factitious disorder imposed on another? And FDIA...

should only be diagnosed when you both interview the suspected perpetrator and review the medical records for fabrications. Again, we've talked a little bit about how they framed Dr. Sally Smith's role in an incorrect way, but they made a big deal of the fact that Dr. Sally Smith only spent 10 minutes talking to them. But it's not really, it's not her role to evaluate the child's health. 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. So that is not something the fact that she spent, you know, they frame it as she spent a few minutes talking to this family and just made her mind up. And that's not what happened. 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. 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. 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 Munchausen by proxy in Beata in December of 2015, a full report.

eight months before this investigation kicked off. And that's another doctor having the same concerns. And there was another hospital that had reported her as well. There was a hospital that she had seen. There was a rehabilitation nurse there.

that actually made a report. One doctor just put it in his notes, I believe, and then there was another doctor that actually called it in. 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. 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? That really points away from, oh, this is all at the feet of one overzealous doctor. Right.

Well, and I think it's also important to point out that, you know, a hospital like John Hopkins is a huge place. You're 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?

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. She opted to remain anonymous for this interview because of her proximity to this case. 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 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. That's why documentation becomes so important. And then they use, the court uses that information to determine if the child is sheltered. So the physician does not make decisions.

neither does the social worker at the hospital. That call has not come from them. That call is made by a judge. Correct. 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. That's who's in the position to make that call. The film presents Beata's behavior at the hospital as suspicious.

Pushy, the defense attorney describes it as she offended someone over there. And here's that audio from the documentary. I think she could be a little too direct sometimes. And maybe some of the doctors took that offensively. I believe somebody at All Children's Hospital was offended there.

And a conflict started. And they sort of say she was being very insistent. She was saying, I know my child. This is the treatment that works for her. And again, from the documentary. Her concern was merely administering ketamine over and over more and more and more. She was belligerent.

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. Her daughter could die from this, and it didn't seem that she was, you know, worried about that.

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 she was not asking them to give her Tylenol. She was asking them to put her in a coma and give her an infusion pump in her spine. So that was what Beata was insisting upon. 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. She said...

Things such as Maya is in so much pain she wants to go to heaven. 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. She doesn't want to live like this anymore. And these are things that she said in front of her daughter. So this is not the only time that Beata had talked about

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

Beata was getting IV Dilaudid, which is an opioid pain medication for Maya to be administered at home from Dr. Kirkpatrick. She asked the IV infusion company, which is the one where she worked, for terminal to be placed on the diagnosis for the medication. 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. Kirkpatrick, who said that is out of his scope of practice.

to put terminal on the prescription. And also, I have to say, I was struck by the second half of that letter from Dr. Kirkpatrick, which told Beata to seek out resources from her local hospice care.

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. 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, 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. Kirkpatrick, at least at that point, was not comfortable saying,

adding that word. We can't know for sure why Beata was making that request.

We know that Maya was already receiving a very high dosage of ketamine. What could a reason possibly be that someone would add? Like, what is what's the purpose of adding terminal to a prescription? Like, do the insurance companies treat it differently? Does that permit a higher dose? Does it permit more coverage? Like, what could some possible reasons be? I mean, my my thoughts, at least from experience, would be that there are doses of pain medications you can use regularly.

at home legally, because now there's a lot more restrictions as well in cases of palliative care, hospice care versus just a child who may need pain medication. 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.

as well as the fact that insurance companies may question if there aren't certain terminology. We're asked sometimes, oh, did you mean failure to thrive or did you mean malnutrition? Because there's a word that the company would say, oh, you just didn't use the correct terminology. And that terminology may be correct in that case. But asking you to put something on a prescription that is

is not correct, at least in your medical opinion, is an interesting piece, especially something that involves the word terminal, is just strange. Yes, it is strange. Now, eventually, Beata was successful in getting terminal added to Maya's prescription. 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. Kirkpatrick.

They questioned Dr. 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 Schott. Now, this testimony is happening years after the fact. There are several possibilities. It could have been a genuine miscommunication. He could easily not remember a conversation he had many years ago. That's perfectly possible.

But it does raise questions as to how this label got on there. There were a lot of things that Dr. Kirkpatrick said in the documentary that came off very strange. Here's a clip from the documentary of him talking about a message that he sent to Beata while Maya was at Johns Hopkins. This was not the first time I've seen this type of scenario. After a few days at the hospital, they refused to give her ketamine.

And without the high dose ketamine treatment, she had virtually no mobility in her legs at all. And that's where you get these blood clots forming which can break off, go to the lungs, and it could be fatal. And I felt it was important that Beata understood the seriousness of this. So I warned her in all medical probability that Maya would die a slow, painful death.

The whole timeline of Dr. Kirkpatrick's treatment with Maya is very striking. So this is a child who has her alleged onset of these symptoms in July of 2015. And her first meeting with Dr. Kirkpatrick, where she officially gets diagnosed by him with CRPS, is just a few months later in September of 2015. And this is a child who has been diagnosed with CRPS for a long time.

And by that fall, she had already escalated to doing these four-day ketamine infusions. And Dr. Kirkpatrick had sent them down to see Dr. Cantu in Mexico, who performed the five-day ketamine coma procedure. This is the procedure that notably has a 50% chance of death. And this for me...

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

So I had lots of questions about Dr. Kirkpatrick. And in fact, another piece of his testimony was just released into the public record. This one is from 2022. 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. And I think it's important to have this information to give some context for what he says in the documentary.

Number one, the language that they are always using to describe Dr. Kirkpatrick. Dr. Kirkpatrick is not board certified in either pediatrics or neurology. He is an expert in the treatment of CRPS using ketamine.

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. This is also the subject of his research. 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.,

Importantly, also in the film, he's very critical of Dr. Sally Smith for not including notes on the phone call that they had in October of 2016 in her report. So another important piece of information that comes from his testimony is that Dr. Kirkpatrick, by his own admission, is doing pro bono work on behalf of the Kowalskis. He says this in his testimony that he created a, quote, roadmap of what he believed happened in this case and

And he provided this roadmap to the producers at Netflix. There are a few other things that struck me about Dr. Kirkpatrick, both in his testimony and sort of the way he speaks in the film. He uses really hyperbolic language. He refers in his testimony to Maya being incarcerated at Johns Hopkins Hospital.

That is really notable language for a doctor to use about one of the most highly respected medical institutions in the country. That is notable. And I just have to say, there is a moment where he nods off during his testimony. That doesn't necessarily tell us anything about his testimony personally.

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So Dr. Kirkpatrick does not have any training in child abuse pediatrics, and he has never worked in child abuse prevention. And I know this because the lawyers asked him these specific questions.

So as we mentioned, he only saw Maya in his office a few times. He was not treating her for a long period of time. His relationship with her only goes back a year before the Johns Hopkins hospitalization. And as we discussed, he does not have any experience or certification in pediatrics.

So the reason that Dr. Kirkpatrick only saw Maya a few times is that none of the treatments that he offers at his clinic are covered by insurance. He claims in his testimony that that's because his surgery center is a non-profit.

It is not in and of itself a nonprofit. He does have a research institute that appears, from what I could find, to fund research done solely by him. This research institute is a 501c3, but his surgery center, in fact, is a cash-only practice. This is all information that's available on Dr. Kirkpatrick's website and in the filings for his 501c3. I did reach out to his surgery center and his team for comment, and they did not respond.

So this was the reason that the Kowalskis started going to Dr. Hanna. And we will talk more about Dr. Hanna in an upcoming episode. So...

When it comes to Dr. Kirkpatrick, there are two possibilities here. 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. And she was desperate to help her daughter and she followed that advice. There is another possibility.

The other possibility is that she was looking for someone to give her the most extreme treatment possible because that is something that offenders do in these cases. This is something we talked to Dr. Carol Jenny about. There are outlying doctors that just suck up these cases. You know, there are cowboys out there who just have beliefs.

That, oh yes, everybody they see has Pott's disease or everybody they see has chronic Lyme or whatever. 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. And one would imagine that medical child abuse is overrepresented. Oh, yes. Oh, yes. They just flock to them. There's a problem in the medical care community, too. There's doctors 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.

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. Well, and if the pain never existed to begin with. Exactly, or the pain is totally unrelated. I just wanted to interject here that in this conversation, Dr. Carol Jenny and I are talking about generalities, 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. The other problem is that once these kids get to be a certain age,

They're very much part of the problem. 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 to turn that around is really an issue. 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 it.

not understanding...

even their own bodies, 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. 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. Yep. We are working on finding an expert in CRPS to talk directly about this and ask them some questions. 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. So we have put in some calls to the Mayo Clinic, some pain specialists here in Seattle and the University of Washington. So we are working on getting someone to talk to you.

But importantly, as Dr. 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. Like many things, CRPS is something that is diagnosed by observation and report using something called the Budapest criteria, which is a checklist. So...

One last thing to say about Dr. Kirkpatrick. Something I found really interesting reading through this documentation was the story of how Beata found out about Dr. Kirkpatrick. In the movie, Jack Kowalski describes the series of events where Maya has an asthma attack and then starts suffering from debilitating pain. And Beata stays up all night researching, and that's how she finds Dr. Kirkpatrick. But this isn't quite how it happened.

Here's that clip from the documentary. We knew as parents something was wrong and they are not doing enough. So when Beata got home, she didn't go to bed. She researched. And that's when she ended up finding Dr. Kirkpatrick.

In the psychiatric evaluation that a Dr. Duncan did of Beata Kowalski, she talks to a number of her friends. They're sort of character witnesses or just people to tell her a little bit more about Beata and her life. The documentary does mention Dr. Duncan's psychiatric eval because at the end of it, Dr. Duncan says that if Maya legitimately has CRPS, Munchausen by proxy can be ruled out.

Now, as we've addressed elsewhere, this is not true. 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. This is from an interaction with a friend that the evaluator spoke to named Jessica Stevens. My producer, Tina, is going to read it for us. I first came to know of the Kowalski family in August 2015. ♪

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

Worse than that, she was in constant agonizing pain that was hard to control and getting worse as time progressed instead of getting better. Listening to her, my father sympathized, having gone through a similar struggle with me, and suggested she consult with Dr. Anthony Kirkpatrick in Tampa. 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. Kirkpatrick and diagnosed with RSD-CRPS.

She was scheduled to receive a round of ketamine infusions at his treatment center. 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. 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. 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. So when she says her doctor's in the hospital, she's almost certainly talking about this Tampa General hospitalization, which was one of the other times that Beata got reported to CPS.

One of the other things that really struck me actually in Dr. 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 very dehydrated and

There was another moment in Dr. Kirkpatrick's testimony that was recently released that caught my eye. The lawyer who's 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 he asked if after your infusions in October of 2015, did you come to believe the disease was permanent?

And Dr. 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. 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. It became a very serious situation at that point.

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. Now, whether or not he was advocating for her to be put in a ketamine coma, which is actually what Beata was requesting at Johns Hopkins, I don't know. 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. And yet here, by his own record, she was deteriorating after getting these treatments. 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.

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.

So, again, 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. And also, these things around food and eating are a huge part of these cases, as we know.

So one of the other recently released pieces of testimony is from Dr. 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. So one of the questions that they asked Dr. Cantu was this.

whether or not all other treatments should be administered before doing something as extreme as a ketamine coma. And he says basically, yes, they should. All other modalities of treatment should be tried before this. 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. So this is people who are having just...

full body CRPS, which is, again, extremely rare, but is something that's known to happen. And we see even in a lot of the video presented in the documentary that the

She's confined to a wheelchair. It's allegedly really affecting her lower extremities. So this question of the full body CRPS just seems a little hazy. The other thing I think that really stuck out, you know, when he's describing the actual situation

set up 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 PICC line that they have to put in because the patient is being put in a coma. And so their airway can be constructed.

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. 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.

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

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

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. And in the next episode, we are going to take a deep dive with Detective Mike into the police report about Beata Kowalski and the transcript of the interview between the detective and Jack Kowalski. That's next time on Nobody Should Believe Me.