Pod Insights Betrayal Introducing: Nobody Should Believe Me — The Catalyst | EP 1 About this episode Welcome to Season Seven of Nobody Should Believe Me. Andrea revisits the case of Maya Kowalski—the story at the center of the Netflix film Take Care of Maya–and the family’s high-profile lawsuit against Johns Hopkins All Children’s Hospital. What became widely framed as a story about “medical kidnapping” began when hospital staff reported suspected medical child abuse after Maya arrived with a history of extreme ketamine treatments.
How did a case of horrific abuse become a story about evil doctors kidnapping children?
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Transcript 10,158 words · 8 speakers
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2:39 Speaker 06 Please note that this show discusses child abuse, which may be difficult for some listeners. For resources about abusive head trauma, go to shakenbaby.org.
2:49 Speaker 06 Take Care of Maya Trial. New details as well on the Take Care of Maya Trial. Well, Maya Kowalski and her family have waited now five years to hear a verdict in their $220 million lawsuit against Johns Hopkins All Children's Hospital. It is the conduct of Johns Hopkins All Children's Hospital, in fact, harmed Maya Kowalski.
3:10 Speaker 06 What happened to Maya? That was the question posed by Diane Neary in her viral feature for New York Magazine that ran in the fall of 2022. There was that headline, along with a close-up of Maya Kowalski's eyes. I remember reading this article long before I'd end up reading thousands of pages of court documents, medical records, testimony, and police records about the case, and thinking, I don't think this reporter understands what actually happened here. And then, of course, there was the Netflix film. No matter what we did, the court sided with the hospital staff.
3:49 Speaker 07 Judges don't care about evidence. You don't get to the truth by accepting what's in front of you without questioning it. And I realized that this was a lot bigger than just the Kowalskis.
4:00 Speaker 05 How many times are you allowed to be wrong and destroy lives before they say, okay, that's enough?
4:07 Speaker 07 These families walked in hoping for help for their child, and some of them walked out in handcuffs.
4:17 Speaker 06 And this was followed by a high-profile court battle. Nobody should believe me had been on the air for about a year at this point. And this was the biggest story about Munchausen by proxy since Gypsy Rose Blanchard. So I felt like I needed to address it. I pulled in some experts for a roundtable discussion about the film. My impressions were it was a huge opportunity lost. What they could have done is looked at the actual issues in this abuse. They could have looked at, you know, in this case, there was a- And that was all I originally planned to do. But everyone else just kept getting it so wrong. But it is not the person who's doing the medical record review's job to interview every doctor. It's to look through those records. And that is how you put one of those- How do you get that?
5:02 Speaker 06 Why do you believe that that's the case? If she is making, if she is the sole person making the recommendation to the judge, the judge is relying on her report- She was not the sole person. She was not the sole person. I'm sorry. There was affidavits and testimony from numerous other doctors at Johns Hopkins. No affidavits and testimony in the court? What actually happened to Maya Kowalski is that she was the victim of extremely well-documented Munchausen by proxy abuse. In the year preceding her fateful hospitalization at Johns Hopkins All Children's, Maya Kowalski was subjected to 55 infusions of ketamine, a powerful drug that can cause hallucinations, memory loss, and bladder issues, among other side effects.
5:47 Speaker 06 Her treatment course also included a highly experimental five-day ketamine coma in Mexico. Dr. Fernando Cantu, who performed the treatment, told Maya's parents that the procedure had a 50% chance of death. Maya was pulled from school, wheelchair-bound, and dangerously underweight. Her mother, Beata Kowalski, an infusion nurse by trade, administered ketamine, Dilaudid, and other drugs orally, intramuscularly, and into Maya's port at home, often against doctor's orders. Beata talked online and elsewhere about Maya's impending death and pushed to get her daughter labeled as terminal and attempted to seek out hospice care, despite the fact that
6:29 Speaker 06 complex regional pain syndrome isn't a terminal diagnosis. And that diagnosis was handed out to Maya by a dubious doctor after three world-class hospitals diagnosed her with conversion disorder.
6:42 Speaker 06 On October 7, 2016, when Maya was hospitalized with reports of excruciating pain, Beata told staff at Johns Hopkins All Children's that if they refused to administer the unheard-of amount of ketamine she was requesting, that they, quote, "Might as well consult hospice so she can finally get enough medication and just let her die." So how did such a clear and obviously life-threatening case of abuse get twisted into a story about evil doctors kidnapping a child? What was going on here? Once I started pulling at this thread, I couldn't stop. The case and the civil trial consumed my life for months.
7:24 Speaker 06 We just recapped this case in a mini-series, by the way, if you don't have time to listen to the previous 18 episodes I made about this. I ended up covering the trial as it unfolded over eight weeks, ending in a jury awarding the Kowalskis $261 million. And two years later, the story continues to unfold. Late last year, a Florida appeals court vacated the verdict, and the Kowalskis' request to reconsider the appeal decision was denied. And as all this has been playing out in court, the impact of Kowalski v. Johns Hopkins has been felt far and wide. Because as reporter Daphne Chen said in the trailer you just heard, this has always been bigger than just the Kowalskis.
8:07 Speaker 06 Kowalski lit the match, and no matter what ultimately happens in their court battle, the fire won't easily be contained. People believe their eyes. That's something that is so central to this topic because we do believe the people that we love when they're telling us something. If we didn't, you could never make it through your day. I'm Andrea Dunlop. Welcome to season seven of Nobody Should Believe Me.
8:47 Speaker 06 The Kowalski's legal battle had already been going on for years by the time this story got traction in the media. Jack Kowalski filed his original lawsuit in October of 2018, two years, almost to the day, after Maya was originally hospitalized with the defendant, Johns Hopkins All Children's.
9:05 Speaker 07 So, the original lawsuit against Johns Hopkins All Children's Hospital, brought by the Kowalski family, alleged a lot of things, some of which were dismissed before trial. The original lawsuit brought claims for everything from malicious prosecution, for the hospital and their healthcare providers calling the Department of Children and Family Services, reporting suspicions of medical child abuse and neglect.
9:34 Speaker 06 We spoke to Ethan Shapiro, an attorney for Johns Hopkins All Children's, about how this court case and its aftermath have played out.
9:41 Speaker 07 The counts that survived included everything from medical malpractice, for the alleged misdiagnosis of medical child abuse, the alleged failure to give what we consider to be extreme doses of ketamine and other dangerous drugs. There were allegations of battery and there were allegations of intentional infliction of emotional distress, some of which the family alleged caused the mother to commit suicide. As you saw from the appellate court ruling, the appellate court sided with my client, Johns Hopkins All Children's Hospital, ultimately finding that the hospital complied
10:22 Speaker 07 in good faith with the mandatory protection statutes and were not liable for, as a matter of law or as a matter of fact, for the unfortunate death of Mrs. Kowalski.
10:34 Speaker 06 There were two possible far-reaching issues with the Kowalski verdict had it withstood appeal. One is the potential legal precedent set by allowing a family to claim damages against an institution for a suicide, and the other, of course, was holding the hospital liable for reporting abuse.
10:51 Speaker 07 The attempts to hold healthcare providers liable for mandatory reporting under Chapter 39 are rare, but not unheard of. In fact, if you looked at the published decisions, a lot of them are for the flip side, where, you know, for example, a parent whose child was ultimately abused or harmed is suing a state agency or a mandatory reporter for failing to report suspected abuse. Think, for example, you know, in the case of a contested divorce, where a child reports symptoms of sexual abuse to a teacher, and the teacher doesn't bring that forward. You could see a situation where the other custodial parent finds out about that and then would have a lawsuit or potential prosecution against
11:36 Speaker 07 a mandatory reporter. Now, all of that being said, we've seen a spate of these lawsuits more in frequency since the Kowalski case, since the movie, and since the fact that it survived the initial motions to dismiss based on statutory immunity. How often do we see these types of cases go to trial? Incredibly rare. And I think they're going to become more rare now that the Second District Court of Appeal has reaffirmed statutory rights and immunities for mandatory reporters.
12:12 Speaker 06 The Kowalski lawsuit and its imitators position this legal battle very clearly as a parents' rights issue, claiming that, quote, "Dr. Smith and Johns Hopkins All Children's knowingly and recklessly violated Jack and Beata's constitutional right to make medical decisions for their child by refusing to discharge Maya following repeated requests from Jack and Beata, and by conspiring to abuse a process and legislative provisions designed to protect children from imminent harm." And while some of the counts of the lawsuits Such as conspiracy, malicious prosecution, and the First and Fourteenth Amendment claims were dismissed before trial, the spirit of these claims remained. The plaintiff's story was that the doctors had conspired to separate Maya from her mother.
12:56 Speaker 06 They'd known their abuse claims were fake, and they made them anyway. And their wanton disregard for this family had driven Beata Kowalski to take her own life. And these claims have served as inspiration for a number of other lawsuits around the country against child abuse pediatricians and hospitals, from San Diego to Minnesota to Pennsylvania. According to these lawsuits, doctors aren't just making mistakes. They're all powerful entities who are conspiring to remove children from their innocent parents for their own financial gain and career advancement. The terminology varies depending on the venue, but there is, in fact, a name for all of this: medical kidnapping. Like any other conspiracy theory, it's hard to trace the exact origins of the term "medical
13:40 Speaker 06 kidnapping," but it appears to have gained a foothold in parents' rights-focused internet spaces sometime in the 2010s and gained significant traction during the highly-publicized Justina Pelletier case, a precursor lawsuit involving Munchausen by proxy. Medical kidnapping is deeply entwined with the idea that Munchausen by proxy isn't a real form of abuse, that every allegation is necessarily false, a witch hunt against caring moms, and that CPS workers and physicians are hiding behind their legal immunity protections. This concept has even deeper internet origins than medical kidnapping itself, going back to the Mothers Against Munchausen Allegations website, which popped up in the late 90s.
14:24 Speaker 06 Medical kidnapping, like so many things, is a fringe idea that has migrated from the dark corners of the internet into mainstream publications, such as The New York Times and ProPublica. People Magazine, where Take Care of Maya producer Kaitlin Keating worked when she discovered this story, published an article in November of 2025 titled "Where is Maya Kowalski Now? All About Her Life After Getting Medically Kidnapped 10 Years Ago." This was weeks after the verdict was reversed. So how did we get here? And how did hospitals become such a target?
14:59 Speaker 07 So hospitals are in a very unique situation for children that are at risk for suspicions of neglect or abuse, because often healthcare workers are the frontline defense in being able to diagnose it and being able to report it. If you think of a situation where a child would come into a hospital with an unexplained fracture that couldn't be a result of anything other than trauma, and potentially trauma in an area that couldn't be explained in the absence of intentional abuse, the healthcare worker would be the one that would be in the best position to make that call of reasonable suspicion to the Department of Children and Families. Now, in that unique situation where the child's an inpatient in the hospital already,
15:44 Speaker 07 the easiest thing for the courts to do to try to find an immediate safe placement for the child before the court can figure out whether one of the custodial parents or perhaps a grandparent or a relative could be filling in that role, is to shelter the child immediately at the hospital. So hospitals are put in sort of a precarious position that other mandatory reporters don't have to deal with. Think firefighters, teachers, in some states journalists, are never going to be in the situation that the person making the report may also be the person required by order of the court to provide safe shelter to the child in the short and the medium term.
16:27 Speaker 06 And does a hospital, once a child is sheltered there, does a hospital have any choice about whether or not to keep that child there under the law?
16:37 Speaker 07 No, the hospital is required to follow the court order just as anyone would be required to follow the court order. Now, the hospital can make recommendations as to what they believe is in the best interest of the child from a medical standpoint, for whatever medical treatment is necessary. And if you remember back to the Kowalski case, once all children reasonably believed that Maya would have benefited from, you know, intensive inpatient or outpatient psychotherapy to treat whatever her pain syndrome was. They made a recommendation to transfer to Nemours Hospital in Orlando, who are experts in that. So they can make recommendations. But absent an order from the court, releasing the jurisdiction,
17:22 Speaker 07 the hospital has to keep the child in custody.
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18:30 Speaker 03 Even on my antidepressant, I still struggled with depression symptoms.
18:33 Speaker 01 You OK, honey?
18:35 Speaker 03 I'm OK, ish. My doctor said adding Rexulti Brexiprazole could help.
18:40 Speaker 04 When added to an antidepressant, Rexulti was proven to significantly reduce depression symptoms, more than an antidepressant alone. Elderly people with dementia-related psychosis have increased risk of death or stroke. Antidepressants may increase suicidal thoughts and actions and worsen depression in children and young adults. Call your healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions. Report fever, stiff muscles, and confusion, which can be life-threatening, or uncontrolled muscle movements which may be permanent. High blood sugar can lead to coma or death, weight gain, increased cholesterol, unusual urges, dizziness on standing, falls, seizures, trouble swallowing, or sleepiness may occur. Learn about these and other side effects at rexulti.com. Tap ad for PI.
19:20 Speaker 01 Hey, how you doing, honey?
19:21 Speaker 03 OK.
19:22 Speaker 01 OK-ish?
19:23 Speaker 03 No-ish. I'm OK, really.
19:26 Speaker 04 Ask your doctor about adding Rexulti.
19:31 Speaker 06 There are many worthwhile critiques about how child protection is handled in the US, and we're going to dig into those this season. But, and sorry if this is a spoiler, there is no evidence that doctors are conspiring to kidnap children or even making a significant number of incorrect abuse diagnoses. So why has this idea gotten so much traction? What is this actually about?
19:53 Speaker 07 I think what the plaintiff ultimately wanted to try was a civil rights case. And Andrea, when you spoke earlier about this influx of what's been called generously a parents' rights movement, which is always in tension with what may be best for the child, this case was, in the plaintiff's mind, one of those cases in the forefront. They brought constitutional actions that were dismissed. I mean, you heard the backstory from the Kowalskis escaping a communist system with the implication to only find themselves at the center of a deep state conspiracy amongst
20:37 Speaker 07 multiple actors to harm Maya and target the mother for reasons that were never fully explained, at least not with evidence. And as the Second District said, there was no evidence of any intent directed at Biata Kowalski whatsoever. But that was certainly what they wanted to put in front of the jury, and that was certainly one of the things that they thought that they could exploit for the purpose, from my perspective, of drumming up juror emotions.
21:05 Speaker 06 The plaintiff's lawyers and the Netflix film told an emotionally evocative story about a suffering family. But by leaving out so much crucial information, that story obscured a very big question. What would have happened if there hadn't been a report? What if Biata had been allowed to carry on? Should parents just be allowed to give their children 50 to 100 times the recommended dose of ketamine and subject them to experimental procedures that carry a 50% risk of death? According to Jack Kowalski's post-verdict comments in the press, yes. Parents have rights, and...
21:44 Speaker 06 They make the decision for their children. Ethan disagrees.
21:50 Speaker 07 So hospitals are not Burger King. You can't walk into a hospital and have it your way and demand medical care that is wildly outside accepted medical standards. You can't do it for yourself and it's going to draw extra scrutiny if you're going to demand it on behalf of a vulnerable child or a vulnerable adult that truly cannot consent on their own behalf. And that's fine. Our system is set up where we have parents be the natural guardians of the children who are empowered to make reasonable medical decisions. Just the same way that you can be appointed to be the medical guardian for somebody who becomes old and infirm. But it doesn't give the guardian the unfettered right
22:34 Speaker 07 to demand treatment that medical providers know to be dangerous. You know, there are protocols and pathways for the safe treatment of chronic regional pain syndrome, for the safe treatment of conversion syndrome, of factitious disorder, and none of them call for doses of ketamine that I think the evidence showed were 23 milligrams per kilogram per hour, which is more than what you need to anesthetize a 2,000 pound horse. So the parents have rights to direct reasonable medical care, but they don't have an unfettered right to direct and demand dangerous medical care.
23:14 Speaker 06 The question of what rights children should have as human beings isn't a new one. And the tension between children's rights to be safe and cared for and their parents' rights to make decisions on their behalf is something that hospitals have always been caught in the middle of.
23:28 Speaker 07 Hospitals have been dealing with this for years. There are religious sects that do not believe in blood transfusions. So hospitals have attorneys on standby that they call it to in the morning to say, we have a child here who's been in a horrific accident. The child's bleeding out. The only way to survive is to transfuse blood. And the parents are saying that they're object on religious and moral grounds. We file motions with the court. We wake up the judge in the middle of the night. We get an order from the judge for immediate blood transfusions and we transfuse the child to save the child's life.
24:05 Speaker 07 Above what the parents' wishes are. That's the tension in society where your religious rights and your rights to direct medical care, we've decided as a society end when it's going to jeopardize the life of a child. So it's not a new concept. It's not a new concept in the law, and it's not isolated to cases like this.
24:26 Speaker 06 Halfway through the trial, just as the defense was going up, Judge Hunter Carroll ruled to dramatically limit testimony pertaining to Munchausen by proxy abuse. This was baffling, given that the abuse was the reason Maya had been separated from her parents in the first place. Not to mention the fact that the plaintiff had already been allowed to assert in their opening statement and had one witness testify that Beata Kowalski did not have Munchausen by proxy, which they framed as a psychological condition rather than a form of abuse.
24:56 Speaker 07 So I'm certainly not here to criticize tough decisions made by the trial court on evidence, but to your question about whether this particular issue brought in the mother's psychological diagnosis, there could be ways you could start the trial and go through the entire trial where that becomes less of an issue. However, if the plaintiffs are permitted to stand up in opening argument and talk about how the collective "they" set about to destroy this family with an erroneous diagnosis
25:37 Speaker 07 of Munchausen by proxy, or to talk about how even though Johns Hopkins All Children's Hospital made the reasonable medical choice to try to escalate Maya's condition, whatever it may be, to the specialists at Nemours that the family objected to that because of this erroneous diagnosis of medical child abuse from Munchausen by proxy.
26:01 Speaker 07 That, from my perspective, necessitates the defense to be able to justify to the jury that's now heard this testimony for several weeks, to justify that that diagnosis or that working diagnosis, whether it appears in the medical record or on medical billing, was made reasonably. And I think the question that you're getting to next is, if that's true, then why didn't we, watching this trial, get to see all of Sally Smith's detailed reports that the hospital relied on in part in arriving at similar diagnoses?
26:39 Speaker 06 And I think, importantly, with the framing of this, the question is whether there was, number one, cause for concern to make that immediate call, and then was there evidence of abuse that necessitated this separation period and her being sheltered in the hospital? And in fact, there was extensive evidence. And so that's the question. However, the plaintiff did have several witnesses testify that Biotto, including Dr. Chopra, who is not an expert on this, that Biotto Kowalski did not have Munchausen by proxy. And so they were permitted to testify, as you said, in the negative, that this was
27:19 Speaker 06 an outrageous allegation, and that Biotto was a caring mother who was making appropriate medical decisions. So there was evidence allowed to be presented about Munchausen by proxy by the plaintiff. Can you talk about the decision that the trial court made halfway through the trial when it was the defense's turn to present?
27:40 Speaker 07 So from my perspective, sitting at counsel table, it appeared the court wanted to refocus the trial on the remaining allegations, medical malpractice, intentional infliction of emotional distress. And I think there were some battery allegations in there as well. And the court's central question was, what does the mother's state of mind, or whether she suffers from the psychological diagnosis, have to do with whether the hospital provided medically acceptable care to Maya Kowalski? In the abstract, that's a completely fair question, right? Because if you take it one step back further,
28:24 Speaker 07 my client's position from day one was whether this is CRPS, or whether it's factitious disorder, or conversion disorder, or a psychological pain response. The treatment for this is still not wild doses of ketamine thorough enough to anesthetize the horse. Now, back to your question. You know, in real time, from my perspective, and it's just mine, at Defense Counsel's table, we felt it necessary to paint the full picture for the jury so we didn't look like monsters that were coming up with this diagnosis to target the family. But in the abstract, that was the way the court was looking at the question in real time. And, you know, certainly that affected the presentation of evidence after that.
29:09 Speaker 06 Yeah, because while there was quite a lot of evidence that was admitted at trial and during the pretrial period, I mean, this has been one of the benefits as a journalist about reporting on this case is that we just have so much information to work with. There are only pieces of that that were actually presented at trial. I don't think Beyond's blog was ever presented at trial, which was a pretty strong piece of evidence. And so this trial court decision made it so that certain things that even were available to the public were not available to the jury. And then it also meant that the one piece of documentation that really tied all of this together
29:54 Speaker 06 from the person who had, you know, the highest level of expertise about child abuse and who had reviewed thousands of pages of medical records, and that would be Dr. Sally Smith's report, and that was never admitted into evidence. That remains private and sealed to this day.
30:13 Speaker 07 It does. Yes, her report is confidential. I mean, the lawyers have seen it because we had the potential to introduce it in evidence. So I know what it says. Obviously, Dr. Smith knows what it says. The family knows what it says. The family did not want the jury to see it for understandable reasons. But ultimately, the court made the decision that the court made. Based on what I told you, that was what I understood to be the court's logic. You know, the court certainly had their reasons for following it. They were understandable to me in a vacuum. You know, it was, but again, it was frustrating to some degree that that report felt necessary from the defense's perspective to rebut insinuations
30:58 Speaker 07 of these false allegations or that they came out of nowhere. They were introduced by the plaintiff.
31:02 Speaker 06 You know, as someone who tells stories for a living about abuse and specifically about this abuse, you have to really tie it together. It's not, it's not well understood. It's not easy for your average sure to understand exactly what the harm was to this child and what the danger that she was in. But, you know, just in terms of like, the asymmetry in the storytelling, that you have the plaintiff able to tell this very dramatic story, which they did with all kinds of tactics, right? They had a lot of pictures. They played the
31:42 Speaker 06 911 call. They had videos of the family. They had videos of Maya in pain. You know, they used a lot of elements to tell this story. It's sort of, did that decision kind of hamstring the defense's ability to tell a story that actually put the focus back on Maya?
32:06 Speaker 07 Yeah, perhaps. So, again, from the hospital's perspective, and maybe, let me take a step back from that. And this is me talking, right, from my perspective, but it's based on a lot of conversations with healthcare providers. A parent coming in with a different belief of what their child has is not uncommon. And most healthcare providers are not offended by that. Like, healthcare providers are human. Medicine is an art and a science. You have a constellation of symptoms. And sometimes reasonable people can disagree. That's why they call it a standard of care, not necessarily one, you know, correct diagnosis in every circumstance.
32:51 Speaker 07 And where am I going with this, Andrea? So, think about it this way. If somebody comes into a hospital or a doctor and says, "I think my child's got irritable bowel syndrome." And what really helps them is if I give them, you know, an Ensure and two Tylenol when they complain. The doctor could tell you, based on my test and based on my clinical diagnosis and the symptoms, "I don't think your child has that." But if that's the only treatment you're recommending for what you think the diagnosis is, we're not calling DCF on you because you're not putting the child in danger. So merely because the hospital has a difference that, you know, we don't think, and when I say "we," I'm speaking on behalf of basically
33:36 Speaker 07 every certified medical professional with the exception of Kirkpatrick and Hannah, "We don't think Maya has CRPS," says Lurie's Hospital in Chicago, says Tampa General Hospital, says All Children's Hospital, and says everyone else in between. They're not calling DCF. The call was based on the fact that you're hearing evidence of immediate threat to Maya's life, either from the drugs that are being given or what the mother is saying that she's going to do if you don't put my child in a propofol or a ketamine-induced coma. So, you know, going back to your initial question of, you know, how does this affect the presentation of evidence? I think it affects it to the degree that
34:20 Speaker 07 this is not just about a parent disagreeing with what the diagnosis is and, you know, portraying this as, "Oh, you Ivy League people up in your tower think you know what's best for my child." The imminent danger that a child could be in if the parents fervently believe and are disregarding medical advice from several world-class and local providers is where the context needs to come for the jury to understand ultimately why the hospital was making reasonable decisions, both in their medical care and their recommendations for future care.
34:58 Speaker 06 Yeah. So take us to the verdict. What ultimately was the verdict in the award in this case?
35:08 Speaker 07 Gross verdict, I believe, was for 261 million that was set aside slightly by the trial court on some post-trial motions. That verdict has been completely vacated or erased by the Second District Court of Appeal, finding there were multiple errors in the way that the Chapter 39, the statutory immunity, was ultimately applied. So right now, there is no verdict against my client and no judgment that we're liable for.
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36:55 Speaker 03 Even on my antidepressant, I still struggled with depression symptoms.
36:59 Speaker 01 You OK, honey?
37:00 Speaker 03 I'm OK, ish. My doctor said adding Rexulti brexpirizol could help.
37:05 Speaker 01 When added to an antidepressant, Rexulti was proven to significantly reduce depression symptoms, more than an antidepressant alone. Elderly people with dementia-related psychosis have increased risk of death or stroke. Antidepressants may increase suicidal thoughts and actions, and worsen depression in children and young adults. Call your healthcare provider right away to report new or sudden changes in mood, behavior, thoughts, or feelings, or if you develop suicidal thoughts or actions. Report fever, stiff muscles, and confusion, which can be life-threatening, or uncontrolled muscle movements which may be permanent. High blood sugar can lead to coma or death. Weight gain, increased cholesterol, unusual urges, dizziness on standing, falls, seizures, trouble swallowing, or sleepiness may occur. Learn about these and other side effects at rexulti.com. Tap ad for PI. Hey, how you doing, honey?
37:47 Speaker 03 OK.
37:48 Speaker 01 OK-ish?
37:49 Speaker 03 No-ish. I'm OK, really.
37:51 Speaker 01 Ask your doctor about adding Rexulti.
38:01 Speaker 06 I've thought a lot about why the Kowalski story took off the way it did, and how such a well-documented abuse case got laundered to the extent of a sympathetic Netflix documentary and a quarter-billion-dollar verdict in court. It certainly doesn't hurt that Maya is a beautiful white girl with a dead mother, a sort of true crime Disney princess. But I think Beata's absence from this story is what really allowed it to take off. Beata Kowalski was a complicated person in real life, someone capable of subjecting her daughter to unfathomable abuse. She said she would put her daughter on hospice and let her die. I have no reason to believe that she wasn't serious about that threat.
38:42 Speaker 06 But in the retelling, Beata is flattened into an archetypal, self-sacrificing, heroic mother, the one people want to believe in. And because she wasn't around to complicate this picture, the filmmakers and lawyers got to make her into whatever they wanted. And of course, Maya and her younger brother are incredibly sympathetic figures. They've lived through a multitude of traumas in their young lives. But the idea that the doctors were the cause of these traumas, rather than the intervention that likely saved Maya Kowalski's life, is counter to reality. But I have a strong sense that most people watching the film and cheering on the initial jury decision don't have any idea what this verdict actually meant.
39:24 Speaker 07 From my perspective, had this verdict remained, this would have continued to be a massive chilling effect on the ability of mandatory reporters to report their suspicions of medical child abuse, physical child abuse, mental child abuse or neglect, without the fear of being prosecuted in a civil court, being prosecuted in the court of public opinion, and potentially having your life and your finances and your professional license ruined. And unless you're on the front lines of this, I represent hospitals for a living, so I have a lot of people call me with questions.
40:10 Speaker 07 What do you think in this scenario? And I remember one that really haunted me. It was about two weeks after the verdict, and I had a client, a doctor, call me, who was an ER physician, and said, I have a child in here. She's an 11-year-old girl. She's got a severe vaginal infection. And the person who's posing as the parent doesn't seem to speak the same language as her, right? Flashing red lights for child trafficking and sexual abuse. And her question was, if I call this, do I have to attach my name to it? Which in Florida, you do if you're a healthcare provider. Can that be discoverable? And can I be sued?
40:55 Speaker 07 And the answer to all of those questions are yes, yes, and yes. And, you know, what I have to explain in this, while you can be sued, one would hope that, given the fact that you have what I think is more than a reasonable suspicion, that should you be sued, we'd be able to get the case dismissed right away. Which always leads to the next question, then what happened in Kowalski? Right? And I'm not trying to make it so simple to say that, you know, there's no scenario that any mandated reporter could step above or beyond the bounds of immunity, even though I believe in the second district seemed to agree that
41:41 Speaker 07 the evidence was that all children complied in good faith with their mandatory reporting obligations. But imagine if you're in that situation on the front line of protecting children and you are pausing. And that's what I'm talking about in terms of the chilling effect. If it happens in a case that's that obvious, then what happens on the cases that are more in the margins? And when the statute is written where these people can be prosecuted for failure to report a suspicion, not a substantiated belief, but a suspicion, then I think from my perspective, for those two years, the chilling effect was very real.
42:26 Speaker 06 Much of the media surrounding these cases emphasized the idea that doctors and child abuse pediatricians are rushing to judgment. Diane Neary, the journalist I mentioned up top, recently did a season of Serial called The Preventionist, where she hammered her argument against child abuse pediatricians with these words in the series finale. Quote, "I'm saying even one pause, one wait a second, might be the difference between a family staying together or being broken apart." But as Ethan says, there's a very real cost to that pause, and children are the ones who pay it. We don't have to guess what happens when doctors start ignoring warning signs of abuse. The deaths of Olivia Gant and Colin McDaniel
43:10 Speaker 06 tell us how that story ends, how Maya's story could have ended. The fate of Justina Pelletier, whose parents' lawsuit was the precursor to the Kowalskis, shows yet another possible path. The Pelletiers lost their lawsuit against the hospital, but they did get their daughter back. Now, in her 20s, she is deeply impacted by her ongoing health issues. It seems very unlikely that she will ever live an independent life. So the big question now is, did the appeal, which barely made a blip in the media, put us back on the right track?
43:42 Speaker 07 The Second District's decision in favor of my client was, from my perspective, very well-written, very lengthy, very thorough analysis of the way the law is right now. I believe that is going to be a vindication of the rights and duties of mandatory reporters, so long as they're staying within the law, complying in good faith with their rights and obligations under the law. So my optimistic view of this is that the decision in favor of my clients is going to vindicate the rights and responsibilities of all mandatory reporters. Now, the attack for which those of us, and I put myself in that camp,
44:26 Speaker 07 believe that the law should remain broad, that we would like the state to be aware of reasonable suspicions of abuse, the vast majority of which are screened out without any action or any interference of parents' rights. But I think if there's going to be an attack from the camp that believes these laws are too restrictive, that parents should have closer-to-unfettered rights to make decisions of their child, even if, from the mind of a reasonable person, that those decisions are harming a child, I think you're going to see the attacks at the legislative end. Because from the court's perspective, they're interpreting the law as it's written.
45:09 Speaker 07 If you read the Second District's opinion in favor of my clients, they're doing an excellent deep dive into, here's what the statute says, here's what the entire statutory scheme is, and based on our interpretation of the statute, here's what the decision should ultimately be in favor of Johns Hopkins All Children's Hospital. And if people want to undo that, it's not going to be by bringing case after case. It's going to be lobbying for legislators to roll this back. It could be rolled back with something as simple as changing the criteria of mandatory reporters have to report a reasonable suspicion. You could change that definition to say
45:52 Speaker 07 they're only required to report substantiated complaints that are verifiable through a panel of three medical experts that would make the standard for a report so infinitely high, it would only catch those that are so egregious. These are societal questions. And for the past 60 years, society has decided to cast this net very broadly. You're at the front line of this, Andrea, and if you're sensing a sea change, you should be alarmed.
46:24 Speaker 06 As Ethan indicates, I've been keeping an eye on the shifts in these conversations around doctors, abuse, and parental rights. In fact, it's baked into my origin story. My sister Megan Carter was covered in my Hixen Bog series, Do No Harm, along with a whole host of other families who claimed to have been falsely accused of abuse by doctors. And Hixen Bog isn't alone. Similar stories have made the pages of USA Today, The New York Times, Serial Podcast, New York Magazine, and this one really hurt, ProPublica. And as I've tracked these stories, I've noticed a trend. While cases of false accusations of Munchausen by proxy often make big headlines, as they did in the Justine Napolitier case and the Maya Kowalski case, there are a bunch of other cases being ushered
47:08 Speaker 06 in with them that are seemingly much more straightforward physical abuse cases. Munchausen by proxy cases are particularly easy to misrepresent in the media because of how misunderstood this form of abuse is. If you leave enough context out, you can frame a perpetrator as a heroic, embattled mom, especially because perpetrators themselves have often put in years of work to build that image by the time these false accusation stories end up in the press. The media coverage of their cases becomes another part of their whole grift. Another opportunity to play both the victim and the martyr, to pull one over on not just the journalist, but their entire audience. And Munchausen by proxy stories are by their very nature
47:51 Speaker 06 difficult to unravel and get to the bottom of. It's also really important for anyone reporting on child abuse to understand how these systems actually work. Because that pause that journalists like Neary are asking for, it's already happening. There already are systems in place to rule out abuse and protect families from being unduly separated from their children. But that part doesn't make such a juicy headline.
48:15 Speaker 07 So this is my personal opinion on this. It's the same when you watch Law and Order and they skip jury selection because it's boring and long. And, you know, all of a sudden you've got a jury and you're starting. But that's kind of one of the most important elements of this. And until you do it, you don't really realize how much goes into that process. This is the same with the due process rights after a call is made. And there's this perception that, you know, a doctor or any mandatory reporter can pick up the phone and call the suspicion of abuse or neglect. And within moments, the child is taken away from the parents. That's not how it works.
48:58 Speaker 07 There are, as there were in Maya Kowalski's case, there's an investigation. There has to be a well documented file that is brought before a judge, who's going to look at that at multiple stages. The emergency stage, is this an emergency? Where the child's at imminent risk, where I have to put a shelter order in place? Because there's obvious signs of abuse, neglect, sexual abuse, or someone threatening to take the child into hospice to put them under? Is this a situation where, you know, I can do something temporary by saying like, you know, here's an injunction against giving this medication, but everybody cool off and come back in a week? And, you know, the child's going home with the parents? And so.
49:41 Speaker 07 Your listeners have to remember that there's a lot of due process. And from my experience, and I will admit, I don't have a lot of experience in front of the dependency court, but from my, what I would admit to be somewhat limited experience, the judges are very reluctant to start interfering with parents' rights unless they have to. And the other thing I would tell you is, yes, I can completely understand a situation of a mandatory reporter thinking, okay, the child has confided in me that, you know, dad spanks them, right? Something that I think reasonable minds in society can think there's degrees of that,
50:26 Speaker 07 and maybe I don't spank my kids, but we're not going to start separating every child from their parent who gets a swat on the butt, even if I don't think that's appropriate behavior. But if you don't call in something that's setting off your alarm bells, how do you know that's not the fourth or fifth time that child's confided in somebody? Why wouldn't you let the agencies that are, that are trained to track these think, huh, that's the fifth time now that I've got a call from five different teachers saying that that kid was subject to some type of corporal punishment at home that made the child uncomfortable? Maybe we should investigate this because this kid's now come forward five times.
51:07 Speaker 07 And so, so that's the type of thing that when you get rid of the reasonable suspicion standard, you're also getting rid of the ability of trained professionals to track whether there's a pattern that may, in isolation, not seem threatening to the welfare of a child or a vulnerable adult, but over time lets them track potential problems.
51:29 Speaker 06 Do you think that medical professionals would still report if they weren't required by law, but they knew that they would be protected by the law?
51:47 Speaker 07 In my experience, having gone through this, perhaps the most heroic thing that I've heard from my clients that participated in Maya Kowalski's case, who were raked over the coals in the court of public opinion, raked over the coals in a biased movie that gave no effort to give context, intentionally concealed deposition testimony that would have put the hospital in a much more favorable light, were dragged into a forum and subject to intense public scrutiny. When you ask them, was this worth it?
52:28 Speaker 07 Their response is, if it helped a child get onto a road where they detox from drugs that could have potentially killed them, put a child on the road where they're running, where they're back in school, where they're able to maximize their potential, I would do it again. So, you know, when you say all healthcare providers, you know, of course, there are some that are going to wash their hands of this situation. But when you really look at the people that have dedicated their lives to pediatrics, they're not in it for the money. There are much more lucrative areas of medicine that people could go into.
53:13 Speaker 07 I am optimistic that if you tweaked the law, you would still get a lot of people on the pediatric side that would err on doing what they needed to do to protect the child so long as they knew that they had statutory protections should their reasonable suspicion be opposed by somebody.
53:36 Speaker 06 Sometimes Munchausen by proxy cases come to a head in a dramatic moment, the way that Maya's case did. But it's always preceded by a pattern of abuse over time. But so many cases in these compendiums of falsely accused parents are not Munchausen by proxy cases, but cases of abusive head trauma, a form of child abuse that, unlike Munchausen by proxy, involves a specific incident and about which there is a huge degree of medical and scientific consensus on how to diagnose. So how are these stories ending up in the same bucket as Munchausen by proxy? Though the Kowalski case is the main focus of Take Care of Maya, the film widens its lens to four other families who claim they've also been falsely accused
54:19 Speaker 06 of abuse by the child abuse pediatrician, Dr. Sally Smith. And as the credits roll, a montage of families from around the country plays. These parents also say they've been falsely accused by doctors. Here's reporter Daphne Chen in Take Care of Maya.
54:34 Speaker 05 It was January 2019 when I hit publish on that piece about the Kowalski family. And I kind of thought I'd move on to the next thing. But that was when the calls started coming in and the emails started coming in. And I realized that this was a lot bigger than just the Kowalskis. I'm sitting at my desk and I start hearing from more and more families, people who had gone to the doctor for help for their kids and then became the target of the system. These families walked in hoping for help for their child and some of them walked out in handcuffs.
55:11 Speaker 06 And this helps frame Jack Kowalski's legal crusade as addressing a systemic injustice. He's not just dragging his traumatized children through a highly publicized, years-long legal battle for a payday. He's there on behalf of all falsely accused parents who've been victimized by the system. Here's Viviana Graham, one of the other parents featured in the film.
55:32 Speaker 05 This young girl, Maya, represents hope for all of us in bringing Sally Smith down, bringing the system down.
55:39 Speaker 06 This is the framing throughout the varied media stories and lawsuits around the country. Out of control child abuse pediatricians falsely accusing parents is a systemic issue that needs reform. I started off reporting on the Maya Kowalski case from the outside, following the trial and reading huge piles of legal documents. But then midway through my reporting, I got a voicemail. Hi, Andrea. This is Patrick.
56:05 Speaker 06 I am Dr. Sally Smith's son. The media at this time was excoriating Dr. Sally Smith, the child abuse pediatrician in the Maya Kowalski case, calling her vile names and criticizing every minute of tape from her depositions. Seemingly, every family who'd ever been involved in a case that she'd provided an evaluation for sprang forth to claim that it was not their children who'd been the victims, but they themselves, innocent parents who'd suffered at the hands of Dr. Smith. I was the lone voice in the media who seemed to understand that far from being the villain of the Maya Kowalski story, Sally Smith, along with the care team at Johns Hopkins All Children's, had been one of its heroes.
56:47 Speaker 06 People were not happy with me for this take. In fact, my reporting on Dr. Smith landed me my very first death threats. After the trial was over and the quarter billion dollar verdict rendered, I flew down to Florida to interview Dr. Smith. By the time I sat down with her, I knew the Kowalski case up, down, and sideways. And of course, this was Munchausen by proxy, my area of expertise. But I became curious about the other four families in Take Care of Maya who were alleging that they were victims of Dr. Smith. There was one story that really stuck with me in particular, that of the sole male voice in this cohort, a Florida man named Jon Stewart, who claims he was falsely accused of the murder of 15-month-old Nolan Kelly.
57:32 Speaker 06 Here he is in Take Care of Maya.
57:34 Speaker 04 I spent over 300 days in jail before they finally dropped the charges. They ruined my life because of it.
57:44 Speaker 06 In addition to his fleeting soundbites in the film, Jon inserted himself into the courtroom drama by showing up on the day Dr. Sally Smith testified. He confronted her outside of the courthouse and filmed the aftermath, which was shared on TikTok.
57:58 Speaker 01 She's evil. She's a liar. She's a malpractice Sally. She freaking charged me with a crime that I did not commit. The medical evidence clearly shows that I was innocent, and she has never been held accountable. She's freaking medically kidnapped Maya Kowalski. She needs to be held accountable. The fact that you, as a deputy, are not arresting her disgusts me and disturbs me on every level. She has fucking killed people. She has literally killed people. She has freaking abused children. She has harmed children, and I am reporting this to you. I want her arrested for that. Please arrest her for that. She is illegally...
58:33 Speaker 04 Kidnapped numerous children. She has illegally imprisoned numerous parents without any medical evidence.
58:43 Speaker 04 And she has not been held accountable. And I'm begging anybody in law enforcement to do their job and hold that evil psychopath narcissistic scumbag accountable.
58:55 Speaker 06 There were almost no details in the film about what happened to Nolan Kelly or any of the other children. But on my way to interview Dr. Sally Smith two years ago, I read the media coverage of John's case. The most thoroughly reported account of John's case was in the Sarasota Herald Tribune. It featured four pictures of John, two of which showed him in his military uniform. There's only one picture of Nolan. He's standing outside with one of his siblings, pantsless, as one-year-olds often are. He has adorable tufts of curls and his big, dark eyes look up into the camera. I had so many questions about what really happened to Nolan. I was overwhelmed by sadness reading about it. He'd been 15 months old when he died, a month younger than my own son was then.
59:41 Speaker 06 The part of me that was curious to know more was drowned out by the part of me that couldn't bear to. So I let it go. Until two years later, I got a message.
59:52 Speaker 04 Well, I was actually watching Dateline. And a show about Dr. Vega being involved came on. And I was like, you know, I started, I started, I started thinking about some things. So then I asked them, you know, about my case in particular, ChatGPT. And it brought up your podcast. So I looked at it, listened to it, and saw that I felt that you were basically defending Sally Smith erroneously.
1:00:31 Speaker 04 So, uh, yeah, so that's, that's why I reached out to you, because I didn't feel that, uh, that it was right that she basically got to lie again.
1:00:44 Speaker 06 Coming up this season on Nobody Should Believe Me. I think an inevitable conclusion that this is not. Not accidental trauma in the child. The ME ruled this a homicide, right? Yes, correct. One of the main problems with the system is that it is focused so much on poor people that it ends up really missing serious cases of abuse. Then the question is, just because something makes sense, is it true?
1:01:13 Speaker 05 These things that they introduce as speculative is just to throw off the court. The court is not a medical arena. It's a legal arena. We reviewed thousands and thousands and thousands of pages of documents about this child and ended up producing a 45-page report delineating all of the different ways that there was evidence of medical child abuse in the case.
1:01:39 Speaker 06 The arguments were the exact same tactics. I had spent two years exploring with vaccines. I didn't have to go through the whole, let me look into this because I recognized them.
1:01:51 Speaker 05 I think he knows exactly what happened. I think blacking out is just a cop-out excuse. He knows what he did is horrific. I mean, just watching him, I think he's a dangerous person. And I think frankly, if you put this on the airwaves, you may escalate it.
1:02:10 Speaker 04 Parents have extraordinarily strong rights in this country, and children are the ones that have very, very limited rights. Come on. I mean, that's, if you can't get your mind around that, like, there's no point in even talking anymore, seriously. The assumption that being with a parent is always going to be the best solution will always feel wrong to me.
1:02:33 Speaker 06 I will always grieve that I didn't get those years in a situation away from my parents.
1:02:45 Speaker 06 "Nobody Should Believe Me" is written, reported, and executive produced by me, Andrea D'Amlo. Our co-executive producer is Mariah Gossett. Our editor is Greta Stromquist. Story editing by Nicole Hill. Research and fact-checking by Erin Ajayi. Additional research by Jessa V. Randall. Mixing and engineering by Robyn Edgar. Our production manager is Nola Carmush. Music from Blue Dot Sessions, Sound Snap, and Slipstream. Special thanks this week to Ethan Shapiro.
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1:04:44 Speaker 04 Zolair 150mg is a prescription medication used to treat food allergy in people one year of age and older to reduce allergic reactions due to accidental exposure to one or more foods. While taking Zolair, you should continue to avoid all foods to which you are allergic. Don't use if you are allergic to Zolair. Zolair may cause a severe, life-threatening allergic reaction called anaphylaxis. Tell your doctor if you ever had anaphylaxis. Get help right away if you have trouble breathing or if you have swelling of your throat or tongue. Zolair should not be used for the emergency treatment of allergic reactions, including anaphylaxis. Zolair is for maintenance use to reduce allergic reactions, including anaphylaxis, while avoiding food allergens. Serious side effects such as cancer, fever, muscle aches and rash, parasitic infection, or heart and circulation problems have been reported. Please see zolair.com for full prescribing information. Ask an allergist about Zolair. This is an advertisement for Zolair,
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