On
February 28, 2006, two women who hardly knew each other, Darcy Wall and
Susan Owen, walked into a Harris County Constable, Precinct Four
substation together. Darcy was a mother of two children and the wife of a
pastor at a local Bible church. Susan was a nurse in a pediatrician’s
office. They had both been close friends and supporters of a woman named
Laurie Williamson, the mother of three terminally ill children. They
had little else in common other than a deep and growing fear that the
children were in danger, and the courage to do something about it. They
had come to report their friend Laurie for child abuse.
Sgt. Mike
Johnson of the Domestic Violence Unit listened to the two women
patiently. He could see that their concern was genuine and seemed
legitimate, but he was initially uncertain of what to do. Darcy and
Susan believed that Laurie had Munchausen Syndrome by Proxy (MSBP), and
that she was pretending her children were sicker than they really were.
It sounded to Johnson like a problem for CPS to handle, but the women
had already reported the matter to CPS, to no avail. After researching
MSBP on the internet, Johnson determined that it was indeed a form of
child abuse that could result in permanent injury or even death. His
search turned up a news article about a local case of MSBP that had
recently been prosecuted, Kimberly Sue Austin. Johnson decided to
contact the prosecutor who handled the case, and that’s where I came in.
I
had tried Austin less than six months before for injury to a child. She
had injected her infant son with insulin, almost killing him. Further
investigation had determined that she had murdered another infant son in
1993 by either suffocating him or injecting him with insulin. At trial I
had shown that the two complainants, as well as two other Austin
children, were victims of MSBP, also known as “factitious disorder by
proxy,” (FDP), “pediatric condition falsification” (PCF), and, most
recently “medical child abuse” (MCA). All of these acronyms describe the
same type of conduct: The intentional exaggeration, fabrication, or
induction of illness symptoms in a child by the child’s caretaker,
resulting in unnecessary and harmful or potentially harmful medical
care.
In the Austin case, where the abuse had gone undetected for
years, this translated into over 400 doctor visits and
hospitalizations, including several unnecessary invasive tests and
surgical procedures. Evidence indicated she had poisoned the children,
injected them with insulin, and even smothered them almost to death.
Kimberly Austin had even been caught putting Coca-Cola in her son’s IV
in the hospital.
Realizing the danger posed to the children after
discussing the case with Mike Johnson, I told him that we needed to
take swift action and offered to help him with the investigation. But I
also had a warning for him: “I hope you’re ready to work.” MCA
prosecutions were notoriously difficult and time-consuming. From
experience I knew this was going to be no easy task.
We began by
issuing grand jury subpoenas to every health care entity we knew of that
had seen the children. Then Johnson started taking statements and
collecting letters from various friends, family members, and other
individuals who had knowledge of what was going on in the Williamson
household. The picture that emerged was disturbing.
Laurie
Williamson had three children: Tom, age 11, Roger, age 9, and Chrissy,
age 6. They wore diapers since none of them were potty trained, and Tom
and Chrissy were confined to wheelchairs and had g-buttons through which
liquid formula could be pumped directly into their stomachs. Laurie
told everyone that the children had mitochondrial disease and a
regressive neurological disorder, among other ailments, and that they
were not expected to live beyond their teens. The Williamson household
was dark, with heavy shades on the windows, and Laurie kept the
temperature at 62° because she said the children were sensitive to heat
and light. Consequently she kept them indoors and rarely allowed them
outside to play. All three children were on numerous prescription
medications meant to control a host of different problems. Chrissy’s had
to be administered through her g-button as she was never allowed to eat
or drink anything by mouth. Laurie said she had a swallowing disorder
and would choke.
One of the first things Sgt. Johnson obtained
was a pair of letters from the children’s pediatrician. The first, dated
January 10, 2006, and addressed “To Whom It May Concern,” listed out
all the problems with which the three children had supposedly been
diagnosed. Tom, for instance, had “mitochondrial disorder, metabolic
disorder, neurological regression syndrome, global developmental delay,
seizure disorder, hypotonia, status post history of failure to thrive,
gastrointestinal malabsorption, gastro-esophageal reflux, esophagitis,
status post gastric-button placement, hypothyroidism, hypotension,
urinary incontinence, stool incontinence, heat intolerance due to poor
thermoregulation from the metabolic disease state, attention
deficit/hyperactivity disorder, Tourette’s syndrome, decreased acoustic
reflexes in the right ear, obsessive-compulsive disorder, anxiety
disorder, pragmatic language disorder, decreasing IQ scores, sensory
integration disorder, auditory processing disorder, and poor immune
function.” Her assessment of Roger and Chrissy was similar.
The
second letter, written just a few weeks later on March 1, 2006,
represented a 180-degree turn. “It has recently come to my attention
that there are several extremely serious issues in regards to the health
of the children and the possibility of Munchausen’s Syndrome as well as
Munchausen’s Syndrome by proxy with this family.” Now even the
pediatrician, who had been fooled by Laurie for eight years, could
finally see that things were not adding up. The children, still in
Laurie’s care, were in grave danger. The situation called for immediate
action.
I asked Sgt. Johnson to contact CPS and try to get the
children removed from Laurie’s custody. Prosecuting MCA cases requires a
multi-disciplinary, team approach, with cooperation between law
enforcement, health care workers, and CPS. CPS had investigated at least
five previous referrals that Laurie Williamson was neglecting or
abusing her children, but each time, she had been able to convince the
caseworker that her children were genuinely ill and that she was doing
the best she could to take care of them. If we were ever to prove that
Laurie Williamson was medically abusing her children, we would have to
enforce what pediatricians refer to as “therapeutic separation” to see
if the victims got better once they were out of the perpetrator’s care.
Therapeutic separation is always the ultimate proof of MCA. If the
children’s health problems abruptly resolved themselves away from
Laurie, it would be the most powerful piece of evidence I could offer in
court.
On March 20, 2006, after an emergency meeting that Sgt.
Johnson and I attended with CPS officials and caseworkers, CPS took
emergency custody of Tom, Roger, and Chrissy. Shortly thereafter, they
were admitted to the hospital for observation. With MSBP as their
working diagnosis, the attending physicians weaned the children off of a
multitude of prescription drugs their mother had been giving them,
ordered the removal of the g-buttons from Tom and Chrissy, and
eventually discharged them all in excellent health, having ruled out
almost all of the diagnoses their pediatrician had mentioned in her
January 10 letter. Chrissy ate solid food for the first time in her life
without any problem swallowing. Other than some behavioral issues, they
were in perfect health.
The question now was: With what offense
could we charge Laurie Williamson? Munchausen syndrome by proxy and
medical child abuse are not offenses. After reading the final discharge
report from the hospital and the statements taken by Sgt. Johnson, I was
confident I could prove that she had endangered her children according
to the broad definition of Tex.Pen.Code 22.041. But the state jail
felony punishment range hardly seemed appropriate in this situation. In
most cases of MSBP, the perpetrator is caught personally harming the
children in some way: Smothering them, injecting or poisoning them,
tampering with medical equipment, or even deliberately trying to infect
them. Sometimes – if doctors are suspicious – the offense may even be
covertly recorded on video. These acts usually fit the definition of
injury to a child under Tex.Pen.Code 22.04.
But in the case of
Laurie Williamson, we did not even have an affirmative act, much less
one caught on video. Clearly, the children had suffered unspeakably at
her hands, but how could we hold her responsible? I began discussing the
case with Dr. Reena Isaac, a pediatrician specializing in child abuse
and a member of the Child Protection Team at Texas Children’s Hospital.
Dr. Isaac would prove to be my right hand, my “security blanket,” and an
indispensable help throughout the prosecution. I explained the
situation to Dr. Isaac and the charging dilemma it represented. She
pointed out that the children had undergone numerous unnecessary tests
and even surgeries under Laurie’s care and with her consent. As we
brainstormed, an idea began to form in my mind: Could an unnecessary
surgery constitute injury to a child? I went over the legal definitions
with Dr. Isaac, including “serious bodily injury.” Her response was
swift and certain: Any procedure involving general anesthesia created “a
substantial risk of death,” and the surgery itself could cause “serious
permanent disfigurement, or protracted loss or impairment of the
function of any bodily member or organ.”
But doctors had actually
performed the surgeries, not Laurie Williamson. Were we going to claim
their conduct was criminal, as well? I turned to a little used
subsection of the law of parties, Tex.Pen.Code 7.02(a)(1).
(a) A person is criminally responsible for an offense committed by the conduct of another if:
(1)
acting with the kind of culpability required for the offense, he causes
or aids an innocent or nonresponsible person to engage in conduct
prohibited by the definition of the offense.
My theory of culpability for Laurie would therefore involve proving three things:
1. That the surgeries were medically unnecessary.
2. That the surgeries met all the elements of injury to a child with serious bodily injury.
3. That Laurie Williamson intentionally and knowingly caused the surgeries.
I
was so focused on proving this novel theory that it did not even occur
to me that I was attempting to do something never before done in the
prosecution of a medical child abuse case: Secure a conviction based
solely on unnecessary surgical procedures.
The first step would
be to subpoena all of the medical records for all three children and
Laurie Williamson, too. I included her records because a significant
number of MCA perpetrators also exaggerate, fabricate, or induce
symptoms in themselves. This would turn out to be true in Laurie
Williamson’s case as well. For the next several months, I issued grand
jury subpoenas and Sgt. Johnson dutifully served them. To minimize
duplication and confusion, we agreed that CPS, represented by the Harris
County Attorney’s Office, would serve as a central repository for all
records obtained, and that Sgt. Johnson would have his office scan in
the records as PDF files and put them on CD-ROMs. The process was
time-consuming and exhaustive, but eventually we got most of the records
we wanted. They totaled over 40,000 pages.
I then began going
through the records to create a chronology of medical contacts in the
form of a Microsoft Excel spreadsheet. I owe a debt of gratitude to
several interns, most notably Amanda Johnston, who assisted in this
tedious, eye-straining, mind-numbing task. On the spreadsheet, I entered
the date, the name of the patient, the type of event (phone call,
office visit, admission, etc.), the provider, and the complaint and
diagnosis, if any. When I finished, I had documented nearly 600 doctor
visits, hospitalizations, phone calls and other contacts for Laurie
Williamson and her children. I did not even include the speech,
occupational, and physical therapy all three children received at home
three times a week.
Next, I catalogued the records for easy
reference and had Sgt. Johnson scan almost three dozen statements and
letters from various witnesses. To prove my case I was going to need
experts; specifically, pediatricians specializing in the recognition and
treatment of child abuse. They would need to review all of the records
in order to form opinions as to whether the children were victims of
medical child abuse and whether the surgeries in question were
necessary. I already had in mind the physicians I wanted: If I was going
to ask a jury to send Laurie Williamson to prison based on expert
testimony, then I needed that testimony to come from some of the
foremost pediatricians in the country.
I did not want to rely
solely on experts, however. After reviewing the records, I began
tracking down the actual doctors who had recommended and performed
surgeries on the children. After talking to Dr. Isaac, I was targeting
three procedures: A g-button placement/muscle biopsy and vagal nerve
stimulator implantation performed on Tom, and a g-button
placement/nissen fundoplication performed on Chrissy.
Going into
the case, like many people, I believed that there would always be some
“test” or other objective basis before a doctor would perform a surgery.
When I contacted the treating physicians, I asked them for any
objective data that supported the surgeries, independent of information
that came from the mother. To them, the question made no sense.
Pediatricians rely almost exclusively on the history given by the
child’s caretaker. They assume that the caretaker is telling the truth
because the caretaker wants the child to get better. Clinical tests,
while useful, are seldom as conclusive as we would hope, and will almost
never by themselves justify a surgery. The history from the caretaker
and any objective results or observations are given equal weight and are
considered indistinguishable.
In the case of the Williamson
children, I discovered that there were almost no test results or
objective bases for the surgeries that could not have somehow been
manipulated by Laurie Williamson. The gastrostomy tube, or “g-button”
surgeries, in which Tom and Chrissy had feeding tubes implanted into
their stomachs to supply them with formula, had been performed because
they were failing to thrive. Although the children had been losing
weight and were not growing and developing properly, this could have
been caused by simple malnutrition rather that some rare metabolic
disorder. The vagal nerve stimulator had been implanted in Tom to help
control persistent epileptic seizures. But, while a few EEGs had been
abnormal and suggestive of seizures, no actual seizure had ever been
recorded, despite repeated and lengthy tests. Instead, the surgery had
been performed due to Laurie Williamson’s reports that Tom was having up
to ten seizures a day despite being prescribed powerful anti-seizure
medications. Dr. Isaac and other physicians confirmed that none of the
surgeries appeared to have been medically necessary and that Laurie
Williamson appeared to have been pushing the doctors to perform them.
In
April of 2007, once I was satisfied that I had met all the elements, I
presented the case to a grand jury, which indicted Laurie Williamson for
two cases of injury to a child with serious bodily injury and three
cases of endangering a child. The injury cases represented two of Tom’s
surgeries, while the lesser endangering cases covered the broad
mistreatment each Williamson child had experienced. To give the charges
teeth, I alleged the scalpel as a deadly weapon in the injury cases,
which seemed appropriate since it was the instrument used to inflict
needless suffering on Tom. Sgt. Johnson and I tracked down Laurie, who
had moved into a shelter for battered women after losing her children,
and arrested her – at a doctor’s office, of course. And while there is
no evidence to suggest Williamson was ever a victim of domestic
violence, she frequently claimed to be the victim of physical, sexual,
and emotional abuse at the hands of various people, including her
ex-husband, parents, and sister.
With the defendant in custody, I
began preparation for trial in earnest. While some doctors were already
on board, I knew I would need more experts. After all, if I was going
to be asking a jury to send Laurie Williamson to prison based on opinion
testimony, it only seemed fair to present them with the very best
expert opinions I could find. After obtaining approval to hire experts
from my supervisors, I recruited two teams, composed of some of the
foremost experts on child abuse in the nation. The first team
represented Texas Children’s Hospital and Baylor College of Medicine and
would consist of Dr. Reena Isaac and Dr. Joan Shook. The second team
would represent Children’s Memorial Hermann Hospital and the University
of Texas Medical School and would consist of Dr. Rebecca Girardet, Dr.
Margaret McNeese, Dr. Sheela Lahoti, Dr. Kim Cheung, and Dr. Christopher
Greeley. The teams would operate independently and would each form
their own opinions after reviewing the records. Within the teams, I
allowed the physicians to consult with each other, share opinions, and
divide the responsibilities however they saw fit.
I supplied each
team member with a packet of materials: Seven CD-ROMs containing all
the medical records on Laurie Williamson and her children; the completed
“Chronology of Events” spreadsheet summarizing the contacts; a catalog
of the CD-ROM contents; a page of legal definitions; a brief set of
instructions, and; a list of questions they were to answer. I included
on the CD-ROMs copies of all the letters and statements Sgt. Johnson had
collected and instructed my experts to review them, as well, and give
them whatever weight they wanted in arriving at their opinions. Just
like a forensic pathologist trying to determine a cause of death, they
would not be confined to looking at the body only; they could consider
outside sources of information as well. My goal was to have my experts
base their opinions, as closely as possible on the same body of evidence
with which the jury would be presented. Lastly, I gave my experts a
deadline about six months away. Just like lawyers, doctors tend to
procrastinate, and I knew my experts would need plenty of time to review
the records properly, especially with their busy schedules. I also knew
that the defense attorneys would need time to have experts of their own
review the records, so a quick trial setting would not do.
In an
effort to streamline the process, I made a proposal to the defense that
had worked well in the Austin case: I would give them CD-ROM copies of
everything: Medical records, witness statements…everything. In return,
all I asked was that they stipulate to the authenticity of the records
under Texas Rule of Evidence 902. This served two purposes: First, it
would save me the trouble of filing the records with the clerk 14 days
in advance of trial, and, second, it would satisfy my duty to disclose
exculpatory evidence. While the records held no earth-shattering proof
of innocence, they contained many facts that could be argued to be
exculpatory. Perpetrators of MCA are clever, and often they merely
exaggerate symptoms that are really present in the child. The Williamson
children had undergone countless tests, the vast majority of which were
normal, but some of which were either abnormal or inconclusive.
Finally, on some occasions, they really had been sick. The last thing I
wanted was to be accused of hiding evidence. The defense would only be
stipulating to authenticity; they reserved the right to object to items
within the records.
It took more than a year for the case to come
to trial, but on April 4, 2008, we began. I was privileged to have
sitting with me Kate Dolan, a veteran prosecutor in our office and one
of my colleagues in the Major Fraud division. Kate brought fresh insight
and experience to the table, and was vital to the success of the case.
The trial lasted four weeks and we called over three dozen witnesses.
Many were former friends of Laurie who had helped and supported her over
the years. These were churchgoing, traditional, stay-at-home mothers,
some of whom had special needs children of their own, and all of whom
had felt compassion for Laurie. When I made contact with them prior to
trial, I expected them to be ambivalent, perhaps even tearful about the
prosecution, and I tread delicately. When I asked if they were
comfortable with the fact that I would be asking the jury to send their
friend Laurie to prison, their cool, matter-of-fact responses left an
indelible impression upon me. To a woman, every one of these
Bible-studying soccer moms firmly and resolutely wanted Laurie locked up
– for as long as possible. While their support was a welcome surprise, I
was still taken aback at the cold-blooded, dispassionate attitude. Only
later would I understand why they showed no mercy for Laurie: They knew
firsthand what she had done to the children. And it was awful.
At
trial, the evidence proved that for a period of approximately six
years, Laurie Williamson had systematically starved and overmedicated
her children in an effort to simulate and induce the symptoms of various
illnesses. At the same time, she had failed to teach, train, and
nurture her children, while exposing them to countless unnecessary tests
and invasive procedures. The result was that Tom, Roger, and Chrissy
appeared to be chronically ill and developmentally disabled, unable to
perform basic tasks or physically take care of themselves.
The
defendant told people that her children were terminally ill, that they
had a mitochondrial disorder, and that they were not expected to live
beyond their teens. She often said these things in their presence. The
motive for the abuse was to gain sympathy, support, and financial
contributions from various people and entities, including the
government. Laurie Williamson, who was unemployed, lived off of a
combination of child support, disability benefits for her children from
the Social Security Administration, and donations from her friends. From
2000-2005, she received more than $150,000 from fellow church members
(at different churches) and even more than that in donated goods and
services. In 2004, with the help of the children’s pediatrician, she had
even gotten a free trip to Disneyworld, paid for by the Make-a-Wish
Foundation. When the investigation began, she was in the process of
trying to raise over $300,000 to purchase a new, wheelchair-accessible
home and van.
The only problem was that none of it was true. The
children were not terminally ill, they did not have any kind of
mitochondrial disorder, nor did they have any of the absurd list of
illnesses she recited during her fundraising efforts. This list of
ailments, which she had her pediatrician include in the January, 2006
letter quoted above, were possible diagnoes she had “collected” over the
years from various physicians and specialists. She represented them as
confirmed when in fact, in many instances they had actually been ruled
out. Muscle biospies and other tests for the mitochondrial disorder, for
example, had all been either negative or inconclusive.
Laurie
Williamson’s deceptions did not go completely unnoticed. As far back as
2000, teachers and counselors at Tom’s school became concerned that the
once bright, playful preschooler became thin, malnourished, and
lethargic. They testified that he seemed “zoned-out” and that they were
concerned that the defendant was overmedicating him, especially after he
improved during a stay with his grandparents. During a meeting about
Tom, these school officials discussed the possiblity of MSBP. They
decided to begin weighing Tom on a regular basis, and even took the
extraordinary step of drafting a letter to two of his physicians,
expressing their concerns. However, the letter was never sent due to
concerns school administrators had about liability.
Laurie
Williamson responded in the same way she always did when suspicions
arose: By cutting contact with the suspicious party. She transferred Tom
to a different school and ultimately withdrew him entirely, saying she
was going to home-school him. She repeated this pattern with anyone who
questioned her: Her husband, her friends and neighbors, her parents and
sister, her fellow church members. And while few doctors ever doubted
her, if they did she moved on quickly, using HIPPA as a shield and
refusing to sign information releases. In 2002, for instance, after
physicians at Texas Children’s Hospital became suspicious of possible
MSBP, Laurie Williamson moved on to specialists at Children’s Memorial
Hermann Hospital.
Many who had regular contact with the
Williamson family, particularly the therapists who saw the children
twice a week and measured their progress, noted that Laurie Williamson
seemed to seek out new equipment and diagnoses for the children and
consistently downplayed and minimized their progress. She was adamant
that Roger needed a g-button like his siblings, even though he ate
normally when allowed to without any problems. Once, after he had gained
weight at a doctor visit, Laurie came home furious, vowing ominously
that he would lose weight before his next visit.
For two years,
neurologists, geneticists, and other specialists in the UT system
puzzled over the Williamson children, baffled by the wide array of
symptoms their mother described. In August of 2004, Laurie Williamson,
who had undergone a biopsy herself, received good news: She did not have
mitochondrial disorder herself, and therefore she could not have passed
the maternally inherited disease to her children. She continued,
nevertheless, to represent the opposite to everyone else. In January of
2005, she brought the children to one of their last office visits, where
the UT geneticists wrote that their observations of the children were
“inconsistent with the condition the mother describes” and expressed
concern about any further invasive testing. They recommended one final,
simple urine test to determine if the children might have a rare
regressive disorder, though they deemed it unlikely. Laurie Williamson,
faced with the prospect of what she knew would be a negative result,
never brought them in for the test.
Instead, she experienced a
series of major health crises herself, culminating in some seizures
that, despite being diagnosed as psychosomatic, somehow resulted in her
almost complete paralysis. It was at this point, in the spring of 2005,
that her scheme fell apart. Multiple witnesses saw Laurie Williamson
using limbs she earlier had claimed were paralyzed, and a lengthy EEG
during her hospitalization detected no seizure activity. During one
supposed seizure, a friend who was present asked a nurse at Williamson’s
bedside if she was going to do anything to help her. “She’ll breathe
when she needs to,” replied the nurse, and walked away.
Now that
she was pretending to be disabled, the defendant and her children needed
24-hour care. A platoon of supporters began coming into the house to
cook and clean for Laurie. With these kind-hearted women feeding the
children and making sure Chrissy had plenty of formula in her feeding
pump, the Williamson children thrived at long last. Chrissy, a five
year-old who wore size 18 month/2T clothing, doubled her weight, gaining
25 pounds in six months. It became impossible to hide the fact that the
kids were not disabled and did not need all the expensive medical
equipment that Laurie Williamson had obtained for them.
Chrissy
had weighed just 15 pounds on her second birthday. Experts testified
that, with a feeding pump to regulate her nutrition intake 24 hours a
day and in the absence of a metabolic disorder, the only explanation for
Chrissy’s small size and failure to thrive was that her mother was
starving her.
The defendant, however, was still trying to raise
funds, soliciting TV shows like “Extreme Home Makeover” and others to
help in her efforts to build a new house. Donations were pouring in as
generous people offered to pay bills. Concerned that the government
might see the donations as income and cut off her disability benefits,
the defendant asked one supporter, Paula Pedrick, to open a second,
secret bank account in which to hide cash contributions. Alarmed and
uncomfortable, Pedrick refused. As the inconsistencies and lies piled
up, some of the women began comparing notes. Finally, a few of them, led
by Darcy Wall, approached Laurie with a proposal: Laurie should select a
“Wisdom Team” of people she trusted. They would organize help in the
home, provide emotional support, and assist in raising and directing
funds. All they asked in return was financial transparency and
accountability. Laurie refused.
Shortly thereafter, Susan Owen, a
nurse for the Williamson family pediatrician and longtime friend of
Laurie, visited the house for the first time in several months. Her
friendship with Laurie had cooled recently as Susan saw things that
disturbed her. Now she was astounded to see Tom and Chrissy, who were
supposed to be wheelchair-bound, running and playing. The therapists
testified that the children consistently behaved worse when the
defendant was around, and that, rather than excited, the defendant
appeared unhappy when they reported the achievement of a goal or
milestone, often making the excuse that the child was “having a good
day” and minimizing the progress. With the help of their physical
therapists and without their mother around to hinder and undermine them,
all three children had made progress by leaps and bounds. Susan
realized at long last that her friend had been lying to her. A few weeks
later, she and Darcy went to the police and set in motion the string of
events that would lead to the trial.
At the trial, the jury was
allowed to see the “big picture,” including extraneous offenses and bad
acts the defendant had committed against all three children, as proof of
her motive to make the children sick. My experts testified that the
children were the victims of MCA, that the surgeries were medically
unnecessary, and that they fit the legal definition of injury to a
child. Even the doctors who had prescribed and performed the surgeries
acknowledged that they would not have done so knowing then what they
knew now. My experts further testified that Laurie Williamson had
simulated cyanotic episodes in Chrissy by smothering her when she was
just six weeks old, and that, essentially, she had used the health care
system to torture her children.
With the help of Juan DeAnda, a
graphic artist in our IT department, I created a timeline, based on the
“Chronology of Events” spreadsheet, that represented all of the nearly
600 medical contacts for the Williamson family from the birth of each
child. The timeline chart vividly illustrated how the contacts increased
in frequency as the years passed, especially after the birth of Chrissy
in 1999 and the separation and divorce of Laurie from her husband in
2000. In 2001, when the surgeries in question had taken place, Tom had
spent a total of more than two months in the hospital. The
hospitalizations and office visits had continued, usually at least one
per week, until 2005, when they abruptly tapered off after Laurie
Williamson’s supposed medical problems began. In March of 2006, I noted
the removal of the children by CPS with a bold, red line. In the two
years since their removal, the children had combined for a grand total
of four office visits to doctors, three of them for routine checkups.
The point was obvious: Therapeutic separation had worked. The children
were completely healthy.
At last, after nearly a month of trial,
it was time for the jury to decide the case. Following about seven hours
of deliberation, the jury convicted Laurie Williamson of both cases of
injury to a child for the g-button and VNS surgeries performed on Tom.
During closing argument on punishment, I appealed to the jurors not to
give Laurie Williamson a “mother’s discount” just because she had harmed
her own children. Kate Dolan pointed out that the scars the abuse had
left on the outside of the children were nothing compared to the scars
it had left on the inside, and that they would be dealing with the
trauma of the abuse for years to come. I also reminded them of the
testimony from the trial that neither MCA, MSBP, nor any of the other
acronyms they had heard about represented any kind of mental illness.
Many people assume that anyone who harms their own children must be
“crazy.” But Laurie Williamson had been evaluated multiple times by
psychologists and psychiatrists, and had been found completely sand and
mentally competent. Even her own experts agreed she was rational,
intelligent, and free of any psychosis or mental disease. Whether you
called it “Medical Child Abuse” or “Munchausen Syndrome by Proxy,” the
conduct was simply another form of child abuse. Like other MCA
perpetrators, Laurie Williamson knew exactly what she was doing, but
chose to engage in the behavior in order to satisfy her greed.
But
in spite of our efforts, faced with a probation-eligible, first
offender, female in a wheelchair, the jury returned a verdict of 15
years. Undoubtedly some of the women who had trusted and supported
Laurie over the years were disappointed in the verdict and thought she
deserved more time. Fifteen years seemed a paltry sentence compared to
the years she stole from her children. Instead of a childhood filled
with joy and wonder, the Williamson children had a childhood filled with
tubes, wires, needles, and the hopeless, looming prospect of an early
death. But I reminded Darcy, Susan, Paula, and the others that, had it
not been for their courage, the Williamson children would still be in
that house today. They were far better mothers to the children than
Laurie ever was. And with an affirmative finding of a deadly weapon,
Laurie Williamson will have plenty of time in prison to reflect on that
fact.
Mike
Trent was the assistant district attorney with the Harris County
District Attorney's Office, where he began working in 1994. He has tried over 100 felony jury
trials and was assigned to the Special Crimes Bureau, Major
Fraud Division, where he handled primarily white collar crime. A native
Texan, Mr. Trent graduated with a B.A. in English from the University of
Texas at Austin in 1991, and received his J.D. from the University of
Texas at Austin School of Law in 1994. A passion for prosecuting child abuse
cases, Mr. Trent is the co-author of Investigation and Prosecution of Child Sexual Abuse
(2d Ed., TDCAA 2007). He has three children and resides in Texas. Mr. Trent believes that good and evil are not simplistic
concepts and that the struggle between the two forces goes on every
day...especially in the courtroom.
The article first appeared on the true crime website In Cold Blog on
June 5, 2008 and was subsequently published in the July - August 2008
Edition of "The Texas Prosecutor,"
The Official Journal of the Texas District and County Attorneys
Association.