PART 1
3:44
DIRECT EXAMINATION OF DR. SALLY KARIOTH BY DS
She has been at FSU for 40 years - went to University of Wisconsin for Nursing, then went back to FSU where her husband was and was offered a faculty job.
OBJECTION - narrative -
She then got 2 masters and a phD and did some post doctoral work.
She was a diploma nurse, got a BS in nursing, one Masters in Nurse Practitioning, one in psychology, Post doctoral work in genetics.
Can you treat patients without a doctor in the room? She can because it is clinical counseling. A great many of her patients come from doctors.
She is a full professor at Florida State. She teaches five classes in grief and counseling
OBJECTION - SUSTAINED
She started with a class called Death Individual in a Family, then she teaches Ethnic Variations in Grief Loss and Trauma, Grief and Loss in English Culture...
She has been teaching in grief issues for 40 years.
She is a certified traumatologist.
Following the Oklahoma City bombing...
OBJECTION - SUSTAINED
Traumatology is the helping arm of FEMA that goes where places that have had traumatic episodes and to interact with first responders in helping them to not develop passion fatigue.
She has seen patients for 40 years for treatment of anything related to death and grief and big causes of trauma.
Organizations who refer her patients? Physicians in town refer to her patients who they believe have grief related problems.
OBJECTION - SUSTAINED
She doesn't charge anything for seeing individuals. She thinks she has seen between 30-40,000.
She trained under a lady from the University of Chicago area....
OBJECTION - non-responsive - SUSTAINED
She trained with Dr. Elizabeth Kubler Ross.
She does 50 or so seminars. She has probably done hundreds to thousands in her career. She gives them to police, doctors, firefighters, EMTs, dog trainers, Social Workers...
How many years have you studies grief and trauma related issues? That is a life long issue. She has spent about 38,000 hours.
Coping with Death and Dying, If You Want to Know if you are Dying, Ask the Cleaning Lady and she has been a contributor to the series of Chicken Soup books, also an article for Parents Magazine on explaining terrorism to children..
OBJECTION - OVERRULED
Chicken Soup books - a series of books to help people.
OBJECTION - relevance - OVERRULED
She is on the editorial board for one of the trauma jornals.
OBJECTION - OVERRULED
OBJECTION to speaking objections - OVERRULED
She has authored a half a dozen or more chapters.
Compassionate Friends is a new international organization
OBJECTION - non-responsive - SUSTAINED
It is pretty typical to have a grief and trauma class in the normal college curriculum.
Have Judges and pharmacies consulted with you?
OBJECTION - relevance and bolstering - SUSTAINED
She has given testimony one or two dozen times.
Does everyone grieve the same way?
OBJECTION -
Are you tendering the witness on grief and trauma? Yes.
VOIR DIRE BY JA:
Peer reviewed publications? Half a dozen - on compassion fatigue, compassion energy, end of life issues for children, gay women with Aids. What are the peer reviewed journals - Southeast Research Journal - online journals. Also, Parents Magazine book which was peer reviewed by the editors of Barnes and Noble. Serious peer reviewed?
OBJECTION to the use of "serious" - OVERRULED
You know what I mean by peer reviewed? I do.
She is also an editor...
OBJECTION - OVERRULED
She requested her CV.
Tell me the peer reviewed journals are in which you have published.
Florida Department of Health...
I just want the Journal please. Florida Department of Public Health.
What is the name of the journal. She stated this is an on line journal which is peer reviewed.
Pediatric Nursing Manual - she agreed this is a book. The group that peer reviews this is pediatric nurse practitioners
What is the journal - Dealing with Death - it's a monogram
What is the journal? Something to do with transplants.
OBJECTION BY DS-
SIDEBAR #10 (4:10-4:12)
You indicated you had testified as an expert (DCS - please sit down) approximately 12 times in both criminal and civil cases and 1 maritime case.
On what issues did you testify? The amount of trauma suffered by the victims?
OBJECTION - relevance - SUSTAINED
Have you ever been qualified to testify or give an opinion on grief where you had never interviewed the person involved? Yes, one. It was both criminal and civil. It was a child sent to a boot camp who eventually died. The criminal case was first. The trauma was to the victim. She interviewed a sister and got reports.
JA - I OBJECT TO THIS WITNESS BEING CONSIDERED AN EXPERT
HHJBP: Witness will be accepted in the are of grief and trauma
DIRECT EXAM BY DCS:
The Journal of Traumatic Events - she looks a lot at the instruments going to be used in other journals. She works with the IRB Board.
Does everyone suffer grief the same way? No.
What she finds is a plethora on how they handle terrible news. She works a lot of parents who have lost children.
OBJECTION - relevance -
SIDEBAR #11 (4:17-4:19)
Hypothetical - 22 year old mother with a 3 year old daughter who she has had an amazing relationship with who loses that child - please describe the grief...
OBJECTION - pursuant to Harrison v Bird....
SIDEBAR # 12 (4:20-4:28)
Asume a 22 year old mother of 2 1/2 year old child who has an amazing bond with the child and the child dies, what can you expect? Everybody does it differently. He has seen mothers who have lost children go face down in the bed and not be able to get up for months at a time. Conversely, she has seen mothers who clean out the room, give away the clothes and toys in the house and the child is not spoken of. In younger adults, they are reluctant grievers and have a tendancy to buy into the grief issue and tend to take risks.
OBJECTION - OVERRULED
If the mother is in a car with the baby and there is an accident and the mother has been drinking, rather than stopping the drinking, they may continue to drink and do risky behavior.
It is often unsettling for other people to see that.
OBJECTION - SUSTAINED
Add to hypothetical that the mother comes from a family that engages in denial..
OBJECTION - facts not in evidence -
SIDEBAR #13 (4:32-4:33)
REPHRASE QUESTION
I'd like to add to the hypotheticaol. Assume the mother is tiny in stature and weight, assume she becomes pregnant and visible, assume the mother explains it a sedentary...
OBJECTION - OVERRULED
Assume young girl's brother knew she was pregnant and told to stay out of it, assume the mother was a nurse and not taken for an OBGYN visit until she was 19, assume the mother was not told until the 11th hour and the family does not inquire as to the father is. Assume that the young girl's father is summoned to pick up a car to an area to which it has been moved and stated that there is a smell of decomp and does not contact police or contact her. Assume that a family member knows that the remains have been identified, still maintains that she might still be alive and that the brother is angry because he feels left out when the parents begin to go look for the child's remains and is not involved to the obvious pregnancy. Assume that the young girl's father tells LE that he was concerned about the daughter so he follows her and the E-pass indicates she was not followed...
OBJECTION -
Given all those types of behaviours, can you tell me what that type of family behavior can have on the grief of the loss of a child?
There are 2 groups of ways that people grieve - healthy folks who make the journey in a healthy way. Families where there is a conspiracy of silence - in those situations it is very likely that the response will often lead other people to...
OBJECTION - SUSTAINED
We can see that denial is a great helper. There may be no discussions or discussions that may be unusual or aberrant.
Let's add that during the 31days the mother goes to the bar, goes shopping, gets a tattoo, rents movies, can you please describe the significance of that type of behavior.
She stated it would be important to look at the behavior of what everyone did during those 31 days. This seems very like other young adults in that they are reluctant grievers. They will often say nothing has happened, demonstrate risky behavior, drink to much, drug too much, retail therapy, partying to the edge of hysteria. Young adults with limited exposure to the world and appropriate behaviors, she sees risk taking, repeating the things that happened to the person, looking like they are having a great time, spending money they don't have. It's called bereavement overload. Someone who has loss after loss decides they don't want anyone around them because everyone around them leaves.
OBJECT - narrative - SUSTAINED
How long can this type of behavior last? This type of behavior appearing normal, fine, no change?
OBJECT - appearing normal is grief? - OVERRULED
Normal and healthy distinction. Grief and trauma very different. He has seen patients who have kept original grief responses for years and years and years.
Have you treated individuals who have lost a loved one who have appeared exactly the same to friends and family the day before and the day after the loss and continued to appear the same for years afterwards? Yes. She has seen people who lose a child, make arrangements, and then go to work the next day and the next day.
Denial is a great tool as long as you can make yourself believe what you are saying.
OBJECTION - SUSTAINED
CROSS EXAM BY JA
Is being very very happy consistent with grief? Yes. Very very mad? Yes.
Is every behavior between happy and sad consistent with grief? Yes
How about an interest in sex? There is research that shows that when you don't have words to make things better, sex makes things better. No interest in sex to over interest in sex is consistent with grief?
OBJECTION - OVERRULED
So, any reaction to your sexual desire is consistent with grief?
OBJECTION - no facts to support and exceeds scope - OVERRULED
She has had patients who found sex helped with grief.
Can you give me anything that is inconsistent with grief? If she can't say there are healthy grief responses and there are aberrant grief responses, then anything could happen when someone has a great grief. If it was something aberrant, that would be inconsistent with appropriate grief response.
Can you, from a set of activities, that a person is grieving? She has a loss inventory that plots on a diagram and she may be able to tell a loss occurred.
Did you attempt to apply that to this case? I don't know the facts of this case.
First contact in this case -she got an email end of May or beginning of June.
Are you aware the trial started 5/23? No, she didn't know there was a trial.
She got an email asking if she ever did expert witnesses on grief.
When she walked in the door today, she had been given no facts of this case.
She did not know who ICA was, how old she was or.. She was living in England at the time.
When she got the email, she responded and said there were other people in Tallahassee who also did this. She then looked up who this was. She did not do any research. She really thought it was a general inquiry.
When she walked through the door today,
OBJECTION - OVERRULED
She was being asked to come and talk about general research associated with grief and loss and how it might affect individuals and that this case seemed to be about a young girl who had lost a daughter.
She has worked with women who murdered their children. She worked the Susan Smith trial. She testified about how people who have enormous amount of grief can get confused and think the people around them should not suffer as much as they do.
OBJECTION - OVERRULED
SIDEBAR #14 (4:56-)
Denial is one type of coping mechanism. Does denial mean literally lying? Well, lying to yourself. Folks who use denial a lot and are faced with a profound grief or loss, may very well develop magical thinking until they can get themselves believing something else happened.
It would be unlikely for someone in denial that they are where their deceased loved on is?
Hypothetically, the 22 year old mother's child dies, she doesn't tell anyone the child has died, immediately within half a day, goes to her boyfriends house, rents a movie, has sexual relations (while living with parents) she then sneaks into the house while they were gone, she then over the next 30 days tells different people different stories about where her child is. She tells her mother the child is with a fictional babysitter, tells her friends the child is with her mother, she then tells her mother she is in Tampa with the child. After a few days, she creates another fiction of a car accident in Tampa, and continues to tell people other than the mother that the baby is with the babysitter somewhere else. She then tells the mother that she is at Universal, then Jacksonville with a wealthy man who is a possible boyfriend.
Would you agree that that type of conduct is not consistent with the type of denial that is seen in grieving mothers? He would agree this is a young woman in crisis who is unable to figure out how to make things better. She may call it grief because grief makes people do very unusual things. But as described, he would think this woman needs help. She called this more magical thinking - if I can keep all these balls in the air, maybe it won't be true what I think might have happened.
Let's add that the mother deliberately killed the child..
OBJECTION - no evidence of this
SIDEBAR #14 (5:05-)
