Crime Weekly - S3 Ep158: Maya Kowalski: Sickness Turns to Tragedy (Part 1)

Episode Date: November 17, 2023

Maya Kowalski was ten years old when her father brought her to Johns Hopkins All Children's Hospital in October of 2016. The previous year, Maya had been diagnosed with a rare neurological condition called Complex Regional Pain Syndrome which caused her excruciating pain. Consistent therapy and ketamine treatments had gotten Maya’s condition under control, but she would have flare ups from time to time, and one of these flare ups brought her to the emergency room at All Children's Hospital, complaining of pain in her stomach. Maya would remain at the hospital for the next several months, against the wishes of herself and her parents, lawyers would later say. Her mother Beata Kowalski was accused of neglect and medical abuse, and by the time Maya was finally allowed to go home, her mother was dead, having taken her own life after being forbidden from seeing her sick daughter for 87 days. Maya’s family would go on to sue Johns Hopkins All Children's Hospital, claiming it’s actions led to Beata Kowalski taking her own life, devastated that she could not see her daughter and that she was being accused of abusing Maya. The Kowalski family also alleged that Maya was medically kidnapped, battered and abused while in the hospital’s care. This lawsuit would bring to the light deeper issues at Johns Hopkins, issues that affected far more than the Kowalski family and lead many of us to ask the question; if you can’t trust those who take an oath to do no harm, who can you trust? Try our coffee!! - www.CriminalCoffeeCo.com Become a Patreon member -- > https://www.patreon.com/CrimeWeekly Shop for your Crime Weekly gear here --> https://crimeweeklypodcast.com/shop Youtube: https://www.youtube.com/c/CrimeWeeklyPodcast Website: CrimeWeeklyPodcast.com Instagram: @CrimeWeeklyPod Twitter: @CrimeWeeklyPod Facebook: @CrimeWeeklyPod ADS: 1. Hellofresh Go to HelloFresh.com/CrimeWeeklyFree and use code CRIMEWEEKLYFREE for FREE breakfast for life! One breakfast item per box while subscription is active. That’s free breakfast for life at HelloFresh.com/CrimeWeeklyFree with code CRIMEWEEKLYFREE. 2. Talkspace To match with a licensed therapist today, go to Talkspace.com/CRIMEWEEKLY to get $80 off of your first month and show your support for the show. 3. SkyLight Frames The perfect gift for everyone! As a special, limited time offer for our listeners, get $15 off a Skylight Frame at SkylightFrame.com/WEEKLY. 4. Alo Moves Find the health and wellness routine that works for you with Alo Moves! Go to AloMoves.com and use code CRIMEWEEKLYVIP in all caps for 30 days FREE, plus 20% off an annual membership. 5. Helix Helix is offering 25% off all mattress orders AND two free pillows for our listeners in honor of Black Friday! Go to HelixSleep.com/CRIMEWEEKLY and use code HELIXPARTNER25. This is their best offer yet and it won’t last long! With Helix, better sleep starts now. 

Maya Kowalski was 10 years old when her father brought her to Johns Hopkins All Children's Hospital in October of 2016. The previous year, Maya had been diagnosed with a rare neurological condition called complex regional pain syndrome, which caused her excruciating pain. Consistent therapy and ketamine treatments had gotten Maya's condition under control, but she would have flare-ups from time to time, and one of these flare-ups brought her to the emergency room at All Children's Hospital, complaining of pain in her stomach. Maya would remain at the hospital for the next several months, against the wishes of herself and her parents, lawyers would later say. Her mother, Beata Kowalski, was accused of neglect and medical abuse, and by the time Maya was finally

allowed to go home, her mother was dead, having taken her own life after being forbidden from seeing her sick daughter for 87 days. Maya's family would go on to sue John Hopkins All Children's Hospital, claiming its actions led to Beata Kowalski taking her own life, devastated that she could not see her daughter and that she was being accused of abusing Maya. The Kowalski family also alleged that Maya was medically kidnapped, battered, and abused while in the hospital's care. This lawsuit would bring to light the deeper issues at Johns Hopkins, issues that affected far more than the Kowalski family, and led many of us to ask the question, if you can't trust those who take an oath to do no

harm, who can you trust? Hello, everybody. Welcome back to Crime Weekly. I'm Stephanie Harlow. And I'm Derek Levasseur. So just as a quick note for anybody who's watching on video, obviously you noticed that my background is different. We're currently doing renovations or some work in the basement where my recording booth is located. And this will be my temporary recording space for a little while. I don't really know where we're going to go from here, but this is the setup for now. And I am going to do some soundproofing in here to improve the audio a little bit. But I don't know.

It's nice. Easy stuff. Yeah, easy stuff. Easy stuff. Easy fix. Yeah. Easy stuff. Easy stuff. Easy, easy fix. Yeah. No. Before we get into the episode, I said it on Crime Weekly News. If you're listening to this, if you're watching this, it's already passed. You can go back and watch the live. But if you're listening to this, it's Friday morning. Some of you guys get right on at 3 a.m. Today, a little backstory as for anyone who doesn't know, Stephanie and I started

Criminal Coffee Company over a year ago with the purpose of donating funds to cases that needed it in order to solve these cold cases. The first case we chose to do was the Preble Penny case out of Ohio. We covered it a little bit. We went to Utah. We donated to Intermountain Forensics so they could do the DNA testing. Today, if you're listening to this on audio, today at 2 p.m. East Coast time, we're going to be going live on our

YouTube channel. There's going to be a live press conference announcing some major developments in the Preble Penny case. We already know what it is. We want to experience it with you guys. So if you're listening on audio and you have some free time around 2 p.m. East Coast time, join us on YouTube. It's our first case that we did. So this is a big one and we'd love for you to be there. That's really all I had to say. And also thank you to everyone I said last week. Deliveries, they were a big success. We made our first deliveries on Wednesday. I'm sorry, on Tuesday. My brother was the one that actually made the deliveries. He said everyone was super nice.

So if you haven't got it yet, you can still go on criminalcoffeeco.com. We're making deliveries every week. That's all I had. Hope to see some of you guys later today during the live stream. Absolutely. And are you ready to dive into today's episode, which actually was recommended to me by you? Ready to go. This is a big one.

It's on Netflix, all that stuff. So yeah, this is a big one. It's on Netflix, all that stuff. So yeah, this is a big one. On December 10th, 2005, Maya Kowalski was born in Elmhurst, Illinois, to her parents, Jack and Beata Kowalski. Jack was a firefighter and Beata worked as a fusion nurse helping people with treatments in their homes. Beata had fled communist Poland when she was 16 to come to the United States, where she was then told by a high school teacher that she would never make it because she couldn't speak English. But she put herself through college and became a nurse at the cardiac cath lab at Loyola University Medical Center

because whatever Bieda set her mind to, she would achieve. At the end of the day, the thing in life that Bieda was most proud of, though, were her two children, Maya and Kyle. For most of their lives, the two kids played and went to school, and life was good in Venice, Florida, where the family had moved. But then in July of 2015, Maya suddenly became ill. Bieda said that she thought Maya was suffering from a bad asthma attack because initially she had a lot of chest congestion, she had a strange cough, and she couldn't really go outside or else she would just collapse into a coughing fit. So Maya was brought to Sarasota Memorial Hospital where she complained about burning sensations in her legs and feet. She was also experiencing headaches and blurred vision.

Within weeks of this, Maya's feet had started to turn inward, and she could barely walk, but the pain was worst of all. At night, Maya's parents and brother could hear her crying and screaming in her bedroom, and within no time, the Kowalskis began bringing Maya to different hospitals and doctors, trying to figure out what was happening to her and how they could help her. First, Maya was brought to Johns Hopkins All Children's Hospital in St. Petersburg, but none of the doctors there could determine exactly what her diagnosis was. One doctor noted that Maya would begin crying with even the lightest touch to her body, but she was able to stop crying intermittently to converse about things that she was interested in,

like manatees. Initially, All Children's hospital provided a potential diagnosis of steroid-induced myopathy, since Maya had been taking steroid medication that was prescribed to her for asthma, and this could have been causing muscle weakness. The Kowalskis also brought Maya to an immunologist, and Beata told the doctor that she had thought Maya was suffering from bad asthma because she had a lot of chest congestion and that bad cough. But Maya's condition did not improve. And this is what brought Maya and her family to Dr. Anthony Kirkpatrick, a pain medicine specialist who ran a medical clinic in Tampa. This was the RSD slash CRPS

Treatment and Research Institute. Now, both RSD and CRPS are neurological disorders. RSD stands for reflex sympathetic disorder, and CRPS stands for complex regional pain syndrome. And Dr. Kirkpatrick had worked with over 3,000 CRPS patients, so you might say that he knew what he was doing. And even though this is a rare condition, there are doctors that specialize in these things. Dr. Anthony Kirkpatrick was one of them. Dr. Kirkpatrick first saw the Kowalskis on September 23rd, 2015, and he examined Maya. And based on what he observed, he diagnosed her with complex regional pain syndrome or CRPS, which is what I'm going to call it from now on in the video so I don't have to keep saying complex regional pain syndrome. And CRPS is a devastatingly painful and debilitating

neuropathic condition, which is generally caused by damage or malfunction of the central nervous system. This is a very rare condition, but it's believed that CRPS is caused by a short circuit in the spinal cord that basically mixes up pain signals. For example, if a non-affected person were to break their toe, the injury to the toe is going to send a signal to the brain, and then the brain sends back a pain signal to the toe, and this causes the person to feel pain in their toe, and they will probably get some inflammation, swelling, bruising, things like that.

This is going to go on for a few days and then the toe is going to heal and then the pain and inflammation and bruising are going to gradually go away. But in a patient with CRPS, the signals going back and forth between the broken toe and the brain, they get mixed up in that short circuit and the brain continues to send pain signals for weeks or months, sometimes even years. Now, because there are constant pain signals being sent through the body, a patient with CRPS will exhibit things like color changes to the skin, skin lesions, temperature changes, inflammation, and other symptoms such as bone tenderness, stiffness, spasms, limited mobility,

and abnormal movement of the affected limb. The pain experienced by those with CRPS is severe and is described as burning, shooting, stabbing, bone crushing, and unrelenting. Because it's so rare and because many people who experience it are written off as their pain being all in their head, treatments for CRPS vary. But there has been success found in psychotherapy, neurostimulation, sympathetic nerve blocks, spinal stimulations, and pain medication. But at Dr. Kirkpatrick's clinic and others around the United States, medical professionals had found a lot of success in treating the pain in CRPS patients with ketamine infusions

because ketamine effectively blocks pain receptors. This allows the affected person's body to reverse the sensitization process and eliminate the pain. So that's a lot. And that's what Derek was like, you know, are you looking into this case? Because he had brought it up to me and I was like, there's a lot of like medical stuff here that I have to look up. You know, I got to like really understand's happening, if I'm going to explain it. And from what I could tell, this is just a horrible, horrible condition to experience. Sounds terrible. And I'll tell you one thing, not only does it sound painful, but to think both of us as parents, to think I would much rather it be me to have CRPS than my child. That to me is hell. To think that your child is

going through that and there's nothing you can do about it, a million times worse than having it yourself. But continue, I know you're going somewhere with this, but just thinking about that is my worst nightmare. 100%, right? And not only that, we've both had our kids be sick before. They've got the flu, They've got the cold. Aiden broke his arm on his birthday last year. And you sit there and you're tortured with them. And you're like, if I could just take your pain from you, I would at this point. Like I would do anything.

And that's just for such a short time. Somebody with CRPS is going through this for years, you know, and it's constant. Every single day they can't even sleep. They can't do anything. Maya had to stop going to school. I remember when her brother Kyle testified, he said it was so difficult because he would go outside and play with his friends and he would see her, Maya, his sister, sitting in the window looking out at them, very sad because she just couldn't play with them. She hurt too badly. Her feet turned inwards. She couldn't support

her own weight anymore. And she was just in so much pain and it's stealing her childhood. And as a parent, you keep bringing her to doctors and they're like, we don't know what it is. It could be this, it could be this, it could be this, but we don't really know. And there's nothing we can do to really ease her pain. Yeah. No, it's terrible. But I think the big takeaway for me, because I kind of know I'm not going to sit here and play ignorance that I haven't seen some of this, the narrative of what this story is about. This is a real thing. This is a real condition. This isn't something that's being made up in Maya's head. So that is as, as tragic as this isn't as terrible. It is as a parent.

It's a real condition that is, that is, has some scientific backing behind it. Now, obviously the treatment, and I'm sure we're going to get more into the treatment and it's, it's a gamut, right? Depending on what doctor you talk to. That's one thing I always say about doctors is obviously very smart individuals, but depending on they're not, there's not like this standard practice for every condition. There are doctors throughout the country who have different ways of approaching an illness or sickness or an injury. Right. And depending on what you believe, one may be better than the other.

There are doctors out there and again, nothing wrong with it, who believe in a completely holistic approach when whenever possible. And there are people out there who would say they're crazy, right? So not every doctor is the same. There's different schools of thought of how to treat and how to target something and isolate an issue and maybe correct it. And also I would say that for different people, different things seem to work. They're more receptive to one form of treatment over another. So I'm just trying to get the baseline here because I don't really know all the factors of this case, although I know the general headlines from what I've heard, but I'm really interested in the foundation of this story and how we got to where we are now with everything we're seeing. So for me, that's what I'm trying to establish here. And my initial

takeaway from this first part is this is a real thing. It's a horrific condition, but it is something that has been scientifically documented and it doesn't appear to be something that's being made up by Maya or her mother, which is, I think, obviously very important when we consider this case. So I've actually seen people kind of split. So to me, when I'm going through this case, I'm like, clearly this girl's experiencing this. She's had several medical professionals who specialize in this diagnose her with it. But then there was people who were like, well, we could see how the hospital might be suspicious. We could see why they might do this. Ketamine is a scary thing to hear. A lot of people, and we're going to talk about that in a minute, but a lot of people hear ketamine and they think like, this is like so strong, a child shouldn't be getting this. But once again, I want to remind you when you're- Doses, right? Well, yeah, she was getting in very high doses too, but there's a reason for that. There's therapeutic reason, there's science and medicine based evidence for why they should be that high,

things like that. The point is when your child is suffering and nothing's working, you know, you've got Vicodin, you've got Oxycontin, you've got the strongest narcotics and opioids out there. Nothing's putting a dent in it. And somebody comes to you and says, listen, this could sound scary, but it also could put her on the right track and soothe her and help her pain. You are going to do it if it's been months and months of hearing your child scream in pain at night. You're going to do it. And so I think anybody who listens to the facts of this case, and I've watched the trial, anybody who listens to the facts of this case and feels like they want to judge

Beata or Jack Kowalski for giving Maya these treatments, they should remember that they have not been in the Kowalski's shoes. They have not had to listen to their child scream in pain at night, not be able to go to school, not be able to walk. And I've heard videos of Maya while she was in this pain. And she's not even my child and And it was heart-wrenching to me. I would have thrown myself on a grenade for her at that point if it would have caused her some comfort. So you don't really understand and to stand in judgment of these parents who,

I will say, from everything I've read and from everything I've learned about them, were incredibly loving parents, incredibly loving parents. To suddenly say that they would become abusive or neglectful is a judgment I don't think you have the right to make. community here, they think ketamine and they associate it with a date rape drug, right? It's when put into a drink, it's odorless, it's colorless, it's tasteless. And it has been used by offenders, by predators to drug their victims, right? And it disassociates them from their surroundings. Unless they're covering their drink, it's very easy. It's a liquid that can, it could get to someone really quickly. And before they know it, they're at this person's house and they don't even know how they got there. So I think that a lot of people hear those tragic stories, those horrific accounts, and they hear it attached to ketamine. So when they think about a doctor prescribing it,

they think, oh, what the heck is wrong with this doctor? Why is he prescribing date rape drugs to a kid? But lots of doctors prescribe it, not just for CRPS, right? A hundred percent. And that's the thing, right? Like ketamine wasn't created for date rape. It was created for a medicinal purpose and it was used by offenders in the wrong way in this. And there's other drugs, obviously GHB, GBL, there's other drugs that, rehypnol, they fall under these classifications that you hear about with date rape, but they all have actual medicinal medical uses for them, even though they're scheduled drugs. So that's something to keep in consideration when you're going forward, thinking about ketamine and that it can be used for good. Ketamine is also used recreationally as like a party drug. Sometimes there's hallucinogenic effects. We're

going to talk about it. But yeah, let's actually take a quick break and then we're going to hear from Dr. Kirkpatrick himself. All right, we're back. So here is Dr. Kirkpatrick explaining when he first met Maya and why he diagnosed her with CRPS. Doctor, when your new patients come in, are you like just trying to confirm that it's CRPS or are you looking for whatever the diagnosis is, CRPS or it could be something else? Well, you have to do the latter. You have to look for everything because that's part of making the diagnosis. You have to rule out all the other possibilities based on the history based on the symptoms based on the signs that you witness you have

to bet you have to be able to rule out these other potential diagnoses or at least you can come up with a differential diagnosis may include more than one thing wrong with the patient so So how did the examination of Maya go? Well, you know, she was in a lot of pain. And after a while working with children, you kind of learn of a way to communicate, to get them to relax and try to bring it down. At 10 years old, it's a challenge, but it can be done.

You can try to get it down so they know that they're part of the discussion with the mother. So I work hard to do that. Now I also invite the child to be part of the discussion. So the first thing we do is, most time when I look at the new patient information form it's something like this and it's incomplete. So I'll go through it and I'll fill in the blanks with them as we go through it. How did Maya appear to you in terms of maturity and intelligence for being my lieutenant? Remarkable.

It's not just intelligence. It's curious. She wanted to know. She's listening to what her mother says. I wish we, you know, you've got a child that's a little unique, different. Not a little, a whole lot different. So she's intellectually curious, very much engaged in the conversation. So did she contribute then in going through and filling out and finishing the questionnaire?

Yeah, they both contributed to that process. All right. So after that, what steps did you take to examine the child? Well I have a pretty much a head-to-toe type of examination because remember what I said you got to look for all the possibilities here not just one thing that you've been doing research on and so the first thing I can say I want to take a history is very very important I mean the history is very important so you're there you're looking for you know whole history. Did it come from, how did this start? And then you go and work through all that process. And so you try to fit all that together and see what kind of, see if you can narrow it down a little bit, what's going on. And then,

of course, there is the examination that takes place. And there I have a pretty much a pretty standard thing from head to toe it's not just look at just the one area and then another thing I do and this is something that that I'm very compulsive about is I want to set things up and do things that leave leave me convinced that I've done a very objective evaluation and what does that involve well that involves uh fighting the tendency to want to be biased. I mean, we always want our patients to do well, right? Right.

All right. So one of the things I did since I started running the surgery center is I set up a new technology or a new methodology for measuring pain, not by numbers. You've heard this whole thing. Is it a one? Is it a two? Is it up to ten, ten being the pain you that's for chronic pain it's almost useless for Q pain it can be helpful but for chronic pain in terms of doing

research it's not very helpful so I wanted to find a way to I could measure without even talking to the patient how much pain they're feeling between their ear lobes and what did you use and what And what I used, I brought it today, I can show you if you want to see, it's a device called an algometer. And what it does, basically, first let me back up a little bit here. When you get CRPS and some other diseases, what happens is time progresses, maybe not initially. The body changes from being a local local phenomena like you hurt your hand or whatever sprained an ankle it tends to progress into the central nervous system and into the the whole body the brain the whole everything gets involved there's a word for it I'm gonna throw the word out then forget it

hyperesthesia you'll find it in them what they call the Budapest criteria so one of the things you're looking for when you do a diagnosis. Hyperesthesia. Alright. And what that means is that all your senses, touch, sound, hearing, smell, they get accentuated so that you become very sensitive. So it was common for Maya to come in with dark glasses on because the light was, bright lights were painful to her but when she came in the one thing that stood out more than anything else is she

was her skin was exquisitely sensitive to light touch again I don't want to use the big words for it but I don't know I don't know what other people have said they've been well educated I don't know what other people have said so far but it's called aledinia. And it's defined as any type of tactile stimulation, light touch, blowing on the skin, is perceived as being painful. She had that. She had a bad case of it. What other symptoms or signs did you know?

Well, she had the aledinia. But the point I want to make is you can touch them and figure out what this technique is called measuring pain thresholds allowed me to not only just detect it but to quantitate the magnitude of it of what she's feeling in her brain. And this device by putting pressure on the skin it gives you a number. It's called the pain threshold. So I tell the patient look I'm going to apply this device to your skin and it'll feel like pressure. But I'm going'll feel like pressure. But I'm gonna increase the pressure and when the pressure turns to a pain signal, say stop. And we do it three times just for statistical reasons. Three times we do that and we get a number.

And from that, and oh by the way, one other thing that's very important, they're blinded. I mean they don't see the numbers. They don't see nothing. So this is what I mean by being objective. So if a child comes in, let's say, whatever, they want to stay out of school, so they're faking their pain, whatever. I can tell without even talking to the child if they are or not by doing this, the pain thresholds. It's a way to distinguish between what they're feeling in their brain in terms of pain signals, as opposed to what's an emotional issue that might be evolving. What if any other signs or symptoms were noteworthy during

the initial evaluation? The other thing that was noted besides the generalized you know the seeing problems and the touch not just in her legs but in her arms and so forth measured with this device was the dystonia. Dystonia is when the muscles contract due to the disease. They just usually, they're curling in. Sometimes they'll actually stretch out, but mostly there's flexion. And it can happen in the hands or in the legs. The interesting thing about it is

when it comes to comparing adults with children, we rarely see it in adults, but we see a lot of it it in children so if a child comes in with dystonia you got to be thinking about CRPS now with this device I'm able to tell you which side is worse the optometer I'm able to tell you was a right side was worse with the CRPS the sensitivity and and she had lesions on that side and they're typically are like look they look they look like little dots almost sometimes, but they sometimes will break up and then they actually become an ulcer

where they break through the skin. I have a few observations that I made during that testimony. First off, the guy seems extremely intelligent. Most doctors do, but some surprise me and they don't sound too smart. He sounds like he knows what he's talking about. A couple of things that I saw or heard that I was pleased to hear, the methodology to judge authenticity, right? The ability to be objective and understand that there may be a case

here where this child before coming in here is being told or taught something in order to get specific results, right? And so, like he said, she was blindfolded. They had an actual form of measurement where he could determine the severity of the pain based on this instrument. Again, she would be blinded, so she wouldn't be able to replicate the results. She wouldn't even know what to say. And so, that's one way to determine the authenticity of the pain and if the condition that she's describing is actually what she's feeling. The other thing that kind of struck me a little bit and he caught himself. Well, one more thing before I go there.

I like that he said at the beginning of it that even though his specific area of study at that point was CRPS, he wasn't looking to confirm CRPS. He was doing a thorough and complete assessment of her to see what she had and to see how he could help her. And it just so happened that in this case, based on the results of that examination, it was determined that she had CRPS. So he wasn't trying to, he didn't already have a diagnosis in mind that he was just trying to confirm. He was being objective starting from the beginning to see where the journey took him. And then the final thing I was about to say, which was tough to hear. There's a moment where he describes Maya looking at her, her mother, because she's

inquisitive. She's interested. She's curious. And he caught himself because he was about to say, I think, I wish he was here to describe. And then he looked at almost Maya in the crowd and I could tell he was like, shit, I didn't that. Yes, I wish he was here. This is terrible. Let me just keep going. But that was my interpretation or that's what I took from that short video. Yeah. So next episode, when we do the next part of this, we're going to talk more about what the defense says and the defense being John Hopkins and all children's hospital and one doctor in particular, Dr. Sally Smith own doctors, their own experts, and they're obviously,

you know, talking to people and having people testify, other doctors who saw Maya. And I remember specifically one doctor says, well, she seemed, Maya seemed for her young age to be way too well-versed on medical terms and, you know, what was going on, et cetera, et cetera. And he said this as if it was a bad thing, right? But you have to understand many things about this. Number one, Maya's mother, Bieda, was a nurse. So hello. Number two, children who grow up with medical conditions, who are brought to doctor after doctor after doctor, they will become more well-versed on these things. And I have a little

bit of experience with that myself because when I was 15, my left leg started swelling out of nowhere and we didn't know what it was. It just swelled up out of nowhere. And we went to doctor after doctor and they were like, we have no idea. We have no idea what this is. We have no idea. And it turned out to be lymphedema. And lymphedema typically is not something that younger people get. But for some reason, it just happens sometimes. And it's very, very rare.

But in that time, the months and months and months of seeing specialists, undergoing the worst kind of procedures, ultrasounds, and they had to put like dye in my veins and look, and because they had to rule out everything. Was it a blood clot? Was it this? Was it that? I knew more about medical stuff and medical terminology than a normal 15-year-old would have. So they say it as if it's a bad thing. And it's a little concerning to me that this doctor who worked for this hospital would see that as something that suggested that either Maya or her mother were creating these symptoms instead of seeing it as the sad thing that it was a child who was struggling with an illness and a condition that she shouldn't have been struggling with.

And it was just unfortunate. And by the luck of the draw, Maya Kowalski happened to get this incredibly rare condition. And also, it's very difficult because people who have conditions like this are often made to feel crazy because there is no clear-cut reason of why it's happening. And so they will be told, like, oh, the pain's all in your head or you're just trying to

get pain medication. You're just here, you're an addict, you're trying to get pain medication. And these people will go so long without feeling heard, without feeling seen, without feeling understood by the very medical professionals that are there to supposed to be helping them. And instead of really digging deep and trying to do the research and figure out what could this be and just believing their patient instead of immediately writing them off as like a drug seeker or an attention seeker. The doctors shouldn't be doing that. Doctors should be doing their research and should be going the full gamut of what their options are. Get on the computer, start researching

these symptoms like Maya's mother did, which is what led her to Dr. Anthony Kirkpatrick, because Maya's mother's over here putting these symptoms in. And she's like, oh, it could be the CRPS thing, because these things match up. And here in Florida, in Tampa, there is a doctor who specializes in this, so I'm going to bring my daughter there. Instead of doing that, this doctor was just like, well, she knew a lot about medicine, and so that was a red flag for me. Like, I get it. Everyone's busy. But this was very unfortunate from start to finish.

I agree. And I had one question and you might have mentioned it and I couldn't find it. I was just looking back at the script. But how old was Maya at the time when she was first brought to the doctors? And how old is she now? Oh, so when she was first brought in, she was 10. So when this whole what Dr. Kirkpatrick is talking about, she was around 10 years old. And the reason I asked that is this is a 10 year old. I have, I have a 10 year old right now. Very observant, very articulate and would absolutely

retain information about her if she was present during conversations with my, with, with her parents or with, with me and a doctor. She would remember those things. And I would like to think, maybe I'm biased, I'd like to think that Tenley would remember some of these bigger words as well because I'm impressed by some of the vocabulary she uses now just from school. If she heard them repeatedly enough, yes, she would. Exactly. So I think it's absolutely plausible that Maya learned this terminology because like Dr. Kirkpatrick said, she was someone who was very curious and was listening because obviously this involved her.

And understandably, she's in a lot of pain. She wants to know why it's happening. So when people are talking about the reasons behind it, I think anybody, regardless of your age, if you're old enough to comprehend what they're saying, you're going to be paying close attention. So how old is she now? So she's 17 years old now. Okay. All right.

And it's her, her brother, Kyle, and her father's still around, right? Yes, her father, Jack. Okay. Okay. So yeah, I believe, I like Dr. Anthony Kirkpatrick a lot. Like you said, he does seem very, very smart. And, you know, he didn't just go right to ketamine, right? It wasn't like he saw this 10-year-old girl and he was like, CRPS, give her some ketamine. At first, he suggested, you know, different things like warm water therapy and the Kowalskis set up solar panels to heat

their pool. They did this for a little while, but they were soon back in Dr. Kirkpatrick's office when Maya's symptoms did not improve, and eventually her feet had turned inward so drastically they were unable to support her body weight and she had to be put into a wheelchair. During that time, Maya had spent a month at Tampa General Hospital where she had done physical and psychotherapy, but nothing had worked. Now, at that point, Kirkpatrick and the Kowalskis were simply concerned with how to manage Maya's pain, which had become unbearable. Now, CRPS is sometimes called the suicide disease because of how intense the pain can be, and because very few methods have been effective in treating that pain. And so people will sometimes just take their own lives rather than live like that one more minute. And that is when Dr. Kirkpatrick talking about 20 minutes ago, as far as ketamine and the perception about it. We hear so much about it in the news. And when we do, it's usually for

really bad things. It's not about the medicinal uses and how doctors are using it every day to control pain and other things. So again, I'm sure as a father, as a mother, you hear a doctor say, hey, I want to give your child ketamine. Understandably, if you don't have a knowledge of it like Bieta did, you'd probably go, whoa, wait a second here, hold on. And I could see how there'd be some apprehension there. Or just as a public hearing, a doctor put a child on ketamine, there may be a general, I guess, an initial thought that may not be in the kindest light. Yeah. Like you would hear it and you'd be like, ugh, is that like the only option?

Yeah, my kid's on ketamine. Yeah. There's nothing else. Jeez, right? Yep. And I mean, even with Beata being a nurse, an infusion nurse, she still was like, hold up. You know, she wasn't just like, okay, let's do it.

She did her research first. But let's go to a break and we'll be right back. Okay, we're back. So first of all, let's get this out of the way. What is ketamine? Depending on who you are, what you're using it for, the answer could be very different. Ketamine is a medical anesthetic that has been approved for use in humans and animals. But many do abuse it

recreationally because of its hallucinogenic effect. It's a dissociative anesthetic that makes patients feel not only detached from their pain, but from their environment. So you can see how it could easily become abused by people who would like to, you know, dissociate from their environment. However, for patients suffering from CRPS, it seems ketamine has become a lifesaver and sometimes the only thing that can put a dent in the pain. Despite its dissociative effects and abuse potential, ketamine has a short half-life, which means it kicks in very quickly. And also, it doesn't last forever, right? It kicks in quickly and it wears off very quickly.

And unlike other pain management options like opioids, ketamine does not cause respiratory depression. And it's supposedly not physically, there's no like physical dependency on it. So there's not any withdrawal, like huge amounts of withdrawal when you're coming off of it or weaning off of it. In addition to its anesthetic effects, ketamine possesses analgesic, anti-inflammatory, and antidepressant effects, which are all positives for individuals like Maya who are suffering from chronic pain. CRPS patients usually have elevated levels of the amino acid glutamate, and ketamine inhibits glutamate's effect on the nervous system. Now, Maya's father, Jack Kowalski, said that Dr. Kirkpatrick compared ketamine infusions to

rebooting a computer. The goal would be to try to stop Maya's brain from giving false signals of pain to her extremities. And like I said, the Kowalskis were not going to rush into anything, especially not something as intense as ketamine infusions for their 10-year-old daughter. So they did their research. They looked into the studies before eventually agreeing to give it a try. Maya at that point was exhausted. She was up all night in unrelenting pain. It was taking a toll on her physical and mental health and taking

a toll on her family who could not stand to see her hurting so much and so often. The scientific and medical research backed up what Dr. Kirkpatrick was saying and Jack and Beata were desperate to ease their child's suffering. I'm going to fast forward in the timeline a bit, but we're going to come back because for a year, Maya was getting regular ketamine infusions every three to four weeks. And these were effective, but they were also expensive, $10,000 for four sessions and not covered by the Kowalski's insurance. So Beata had to pick up extra shifts at work. The family even sold a rental property they owned so that they would be able to afford

the treatments. And seeing the family's financial strain, Dr. Kirkpatrick recommended them to a friend of his, Dr. Ashraf Hanna of the Florida Spine Institute, who did take the Kowalski's insurance and he was able to prescribe Maya ketamine for her infusions. But like I said, the infusion seemed to be working. Maya was getting stronger. She could use her legs again. She was able to go back to school. She was swimming in the pool and playing with her brother Kyle again. And although she was still in a wheelchair, the ketamine had helped the pain and Maya's feet even began straightening out. Her skin lesions went away and her distress seemed much more manageable. So on the surface, ketamine's working, right? Seems like so far,

so good. And again, it just kind of shows the place of Kirkpatrick as far as you talked about, he was getting a lot of money from this, right? He's not in it for the money, but he was getting a lot of money from it. He saw that the family was struggling, found a colleague that accepted their insurance and was willing to hand them over to him, which means that doctor is now going to financially at least benefit from this because the insurance company is going to be paying them. So it seems like, as you said, Kirkpatrick, his mind was in the right place. His heart was in the right place. He cared what happened to him. He was trying to help them even financially. So, but again, to kind of summarize here from the listener's point of view, ketamine, as crazy as it may sound on the surface for people who don't understand it,

like myself, it's working. And it's the proof is in the pudding, if you will, where the actual physical characteristics of Maya are changing. It's not just her saying, I feel better. The lesions are disappearing. Her legs are straightening out. All these things that you just described, those are things that are quantifiable. You can see the pictures before and the pictures after the ketamine treatment and see a difference. Now, I know we're going to get into some alternate theories here as to why those things cleared up. But again, just on the surface, 36,000 feet, that's what it looks like.

Yes. And I mentioned in the teaser to this episode that Jack Kowalski would bring Maya into Johns Hopkins All Children's Hospital in October of 2016. But this was not the first time that Maya had been to this particular facility. In March of 2016, doctors at All Children's Hospital evaluated Maya, and after consulting with Maya's treating physicians, they agreed to implant a port to facilitate her ketamine infusions. The hospital doctors performed a surgical procedure to place a semi-permanent plastic tube through Maya's skin and into the muscle. Following the placement of

the port, Maya continued her ketamine infusions and other specialized therapies for two more months under the care of her treating specialists and her primary care doctors, and this included doctors at ACH, which is All Children's Hospital. In May of 2016, an ACH pulmonologist noted that Maya's condition and pain had significantly improved after consistently going through her scheduled CRPS therapies, including her ketamine infusions. And this was noted in a letter to Maya's pediatrician. Because she had improved so much, by the summer of 2016, ACH had started to wean Maya off her ketamine infusions, and during this process, Maya would begin to have

some flare-ups of her condition. With Dr. Hanna, who was the one who took over for Dr. Kirkpatrick, he noted that she had one of these flare-ups in September of 2016. By the following month, Maya's ketamine infusions were increased again due to her flare-ups, September of 2016. By the following month, Maya's ketamine infusions were increased again due to her flare-ups, which included stomach pain and vomiting. But on the night of October 6, 2016, Maya woke up screaming in agony, begging for someone to help her. And her father, Jack, said this was the worst pain he'd ever seen her in. On the morning of October 7, on advice from Dr. Hanna, Jack Kowalski drove Maya to the emergency room of John Hopkins All Children's Hospital. And after she got out of work, Maya's

mother, Beata, joined them there. And this is kind of when the trouble started. The medical staff wanted to perform certain procedures that would make physical contact with Maya necessary. But remember, any sort of touch was painful for Maya. Even something like applying a blood pressure cuff would have been excruciating. And they wanted to do this. They want to do ultrasounds. They want to do a bunch of stuff. None of the nurses on duty that day had any idea what CRPS was. And so Beata tried to explain it to them.

But when she began talking about the high doses of ketamine that she wanted her daughter to receive, the nurses kind of became sketched out. And it was true that the amount of ketamine Maya was accustomed to getting, it was significantly higher than typical doses for children who did not suffer from CRPS. But Maya's doses were supported not only by her treating doctors, but by documented clinical results for CRPS. So all Children's Hospital staff called Dr. Hanna, who confirmed both Maya's CRPS diagnosis as well as the levels of ketamine and other pain medications that she should be receiving.

But instead of following Dr. Hanna's advice, the Kowalskis claimed that the medical staff at ACH became offended and defensive when Maya's parents informed them that they would need to take certain precautions while treating their daughter to reduce her discomfort and pain. Even though these doctors and nurses admitted, they really had no training or knowledge about CRPS. The nurses brought in a woman named Deborah Hansen. This was a social worker employed by the hospital. And she spoke to Maya and her parents because apparently a parent being uncooperative or not following the orders of medical professionals is considered to be a red flag of like neglect or abuse. So Deborah Hansen

found out that Bieda Kowalski had requested a large dose of ketamine to be given to Maya before the 10-year-old underwent an ultrasound. And this caused Hansen to contact Florida's child abuse hotline, claiming that Beata Kowalski was interfering with Maya's treatments, specifically highlighting disagreements between Beata and the medical professionals about appropriate ketamine doses. And it was true, Beata was becoming frustrated with these people because she was like, this is what she's getting. You've gotten confirmation from her doctor. This is what she needs. If you're going to touch her, if you're going to put her in an ultrasound machine, if you're going to do any of this stuff, she's going to need this so that she's not in excruciating pain. She won't be able

to even sit still during this ultrasound. I'm trying to help you here. And they were getting defensive and being like, lady, this is not possible. We're the professionals here. We know what we're doing. Yeah. We know what we're doing. And we can't give a kid this much, even though her doctor said we could and we should. So they were butting heads.

And this seemed to really cause a lot of tension and cause Debra Hansen to call DCFS. However, that same day, DCF investigators contacted the specialists treating Maya to confirm her diagnosis. They heard from Dr. Hanna and Dr. Kirkpatrick. They heard from Drs. Hanna and Kirkpatrick that Maya's doses of ketamine were necessary and recommended, and they were also shown that Maya had a valid ketamine prescription on file with the hospital that was calling in the complaint. Jesus, this is horror. Okay, continue. I'm sorry. I'm cutting you off. No, you're good. There was also no evidence that the Kowalskis had deviated from Maya's prescribed doses, so the case was closed. All Children's Hospital was notified by DCF that

the case was closed and that they had no legal basis to prevent Maya's parents from discharging her from the hospital. But that's not what the staff at All Children's Hospital told the Kowalskis. All right. So question. A little bit of a jump there, right? So you just talked about this disagreement amongst Bieda and the hospital staff where she's saying, hey, this is what she's on. Not what I'm prescribing her, but what her other doctors are prescribing her, right? And I'm assuming because you jumped there a little bit where now DCF is calling back

the hospital and saying, listen, Maya's parents have the right to discharge her from the hospital. So did Maya get the medication that she should have gotten before being discharged? Or at this point, were they not willing to give her that medication? So Maya's parents were saying, hey, because you're not going to give her what she wants or what she needs, I should say, we're going to take her. We want her discharged. We're taking her. Do we know if she was actually administered the medication that they had requested?

Or was this a reaction to their lack of cooperation where they said, you know what, that's fine. We're her parents. We're going to take her somewhere else. So not at first. At first, it was just like an argument between Beata and the nurses. And then the doctor came in and was like, I'm not comfortable with this. And it was kind of just like, you know, they couldn't they couldn't really come to a compromise. And it wasn't until a few days later when the Kowalskis were like, OK, our daughter's in pain. You're not giving her what she needs. We're going to take her somewhere that we're taking her. OK.

Even then, though, they had already called DCF before the parents said they were going to take her. Right. Just them asking about that high of a dose and not allowing doctors to do whatever they wanted to do. They were questioning them because they had previous diagnosis and they were on a treatment plan. So it wasn't them saying, we're smarter than you. We're saying, hey, this is what she's been on. This is what works.

Not only that, this is the same hospital that- That put in that stint type thing? Yeah, that they did the surgical procedure to put in the port to make her ketamine infusions easier. And it prescribed her ketamine. I mean, I'm not justifying it. It's not justified. Let's put that right out there. This is horrible. But we all have experienced it, right? If any of us have been in the hospital before, you have doctors who are treating you. I was in the hospital at one point for MRSA and there were times where the next doctor on the next shift would come in and completely contradict the previous doctor. And it's like, dude, you have the same file in front of you. Like what is going on here? The previous

doctor just told me I couldn't eat and you're asking me why I'm not eating, you know, all these different things. And so that's just from shift to shift. Nevermind department from department. They're just, the communication process is not that great because it's all about going back and looking at the other doctor's notes. And if it's not put in there properly, whatever, just there can be a major communication breakdown. Again, not justifying any of it. It's all wrong, but that seems to be what's happening here there was no communication breakdown they knew right that she had had that port and you know surgically put in there at the hospital they knew she had a ketamine prescription with that hospital

okay they knew all of this and they still just said it was in the records very clear and and i i'm not sure dude i'm not sure what happened, except like it's an ego thing. Is it possible they missed it though? No, they didn't miss it. They acknowledged it. Or they just disagreed with it? I think it was an ego thing.

Like, oh, these parents aren't gonna come in here and tell us what to do. And if you wanna know my opinion, as a little spoiler here, this is what happens when you give people some sort of power over others, unfortunately. And not everybody, right? It's not with everybody. But when you, and we're going to see this with this doctor, Sally Smith, who I think literally had

a God complex like no one I've ever seen before. When you give people the ability to have the final say, and then you have these parents come in and they're like, no, no, you don't know what you're talking about. There's going to be a little bit of an ego there, like a bruised ego where they're going to be like, well, we're the medical professionals. We went to school for this, even though Beheda did too, because she's a nurse, right? But like, who are you to tell us this? You brought her here for our help. And now you're telling us how to help her. And I think it really kind of started there. And then it was like, well, we kind of have to die on this hill sort of thing now. You know what I mean? If you want to know how I feel about it.

Digging in. Yeah. Like, well, we kind of like, we like showed our ass here. And now it's going to look super unprofessional. It's going to reflect very poorly on the hospital. And not only that, we're going to find that there's a culture of silence at Johns Hopkins All Children's Hospital, which I will say in a lot of these cases that I've looked into when it concerns hospitals and doctors and stuff like that. For instance, a case of a nurse who murdered multiple NICU babies, multiple. And everybody could kind of see the pattern, right? But everyone was afraid to talk. Everyone was afraid to speak up. There is sort of a thing

where they like all closed ranks. And even if you thought your fellow doctor or your fellow nurse was in the wrong, you weren't going to say that. And if you did, you might face repercussions, right? You might face repercussions from higher ups. You might face repercussions from your peers. These are people you work with every single day. And maybe you just kind of want to like, you know, not rock the boat. Well, also you probably have nurses and stuff who are like, I'm not going to question. There's a hierarchy there, right? Like you're not going to question the doctor. That's the doctor. You know, even if the doctors aren't, they're not always doing the daily stuff that the nurses are doing. So yeah. And, and like I said, DCF told this hospital, You have no legal basis to keep this girl here. So the staff at ACH,

they're not going to the Kowalskis and being like, listen, we think you're abusing your kid. And so we're like investigating and we call DCF. And so we're just going to keep you here until we figure out what's going on. No, no, no. That's not what they're doing. They're hiding that while they're doing, they're basically buying time to do an investigation and keeping the Kowalskis and Maya there, even as the Kowalskis are asking to leave, being like, oh yeah, we'll get her what she needs. We'll help her, et cetera, et cetera. And it's kind of scummy.

It's kind of scummy. So on October 9th, still unhappy with the care that Maya was receiving and frustrated that she was still suffering and in pain, the Kowalskis told the hospital staff they would be taking Maya out of ACH. They wanted her transferred to Nemours Children's Hospital in Orlando because they did treat CRPS there. They had people there who were familiar with the condition, so they wanted her transferred. ACH denied this request and also, according to the lawsuit, deflected Maya's parents' concerns while hiding their true motives for wanting to keep Maya there. After being told that the DCF investigation had been closed, hospital staff then reached out to a woman named Dr. Sally Smith for advice.

And then Dr. Sally Smith started her own investigation. And I'm going to tell you about Dr. Sally Smith when we come back from this break. So in order to understand what happened here, we have to know a little bit about Dr. Sally Smith. When she was introduced to the Kowalskis, the staff at ACH represented Smith as being an employee of the hospital. Well, they didn't exactly represent her as that. It's very, it's kind of like a really gray area. They didn't not say that she didn't work there. And she had on like a white coat that said All Children's Hospital on it.

So it kind of seemed like maybe they wanted the Kowalskis to think that she was just a, you know, a hospital pediatrician like any other. But in reality, Dr. Smith was not a hospital employee. She was the medical director of the Pinellas County Child Protection Team. But Dr. Smith was not a state employee either because Florida had privatized its child welfare system in 2004. Smith was actually employed by a company called Suncoast Center Inc. And this company, as well as similar ones across the state, are funded by over $3 billion in public funds. But there's also very little oversight into how effective these companies are at, you know, identifying and stopping child abuse. There's also very little oversight into how many times these companies wrongly identify child abuse cases.

Dr. Sally Smith was one of the 275 doctors nationwide who were certified in 2009 as child abuse pediatricians. This was a subspecialty that didn't even exist until that year, 2009. Now, Florida law requires that nearly all suspected cases of child abuse be evaluated by one of these specialists, and Sally Smith was ACH's go-to expert when consulting in suspected abuse cases. Now, this change in 2009 seemed to have an effect because between 2009 and 2018, there was a 55% increase in child abuse reports filed by medical professionals. But specifically in 2014, something happened that made the urgency to recognize and prevent abuse of children even more intense. The Miami Herald had been investigating a DCF policy known as family preservation,

which is basically what it sounds like. It prioritizes keeping families together, but maybe not for like the right reason, because it seemed like the reason that the state of Florida wanted to do this was to reduce the number of children entering the state foster system. But under this policy, 477 children had died after the state was alerted to potential abuse or mistreatment in their homes. In response, the state of Florida kind of went from one extreme to the other, and they overhauled their child abuse protocols, placing more importance on the safety of the child and placing that above the interest of the parents and the family.

And like, this all sounds great. As somebody who really thinks that more should be done when there is suspected child abuse, I've said this multiple times, I've covered many cases on my channel where children are being abused and the teachers are calling the police and the police are calling DCF and there's, you know, social workers going to the house multiple times. Police are being called to the house multiple times. And then all of a sudden this kid ends up dead and you're like, how did this happen when it seemed like everybody knew? So I completely understand. However, once again, there's a good balance here between wanting to keep a child safe

and completely violating the rights of that child and their family and maybe seeing signs of abuse where there really aren't signs of abuse. And in the medical field, this can be tricky, right? Because you do have these conditions like CRPS, where you're not exactly sure where it's coming from. And is it all in their head? And we can't tell where this pain is coming from. We don't even know if this pain is real. It's just what this patient says. And now this patient is a child. Are they being coached by their parent? Are they being abused by their parent? So it gets very difficult. But Dr. Sally Smith was a doctor. She's a doctor. She's a medical doctor. So once again, there's some

due diligence I think you have to do before you just remove a child from their parents' care, which can cause an incredible amount of trauma to both child and family. And if that's not necessary, then why would you do it? Yeah, no, I agree. And I know we're going to talk more about it as we go through this case, but I do think just like at this point, like you just said, we want hospitals to be cognizant of child abuse and to understand the indications of when it may exist. They want, they have to be observant. They have to be observant. They have to be trained. They have to identify certain actions or behaviors or, I guess, physical traits that would suggest the child is being

abused, right? They have to be able to identify that because in many cases, they may be the only people that witness this where the child comes in for the injuries they receive during the child abuse. Obviously, the kids aren't going to go to the police department, right? So this may be the only people that witness this, where the child comes in for the injuries they receive during the child abuse. Obviously, the kids aren't going to go to the police department, right? So, this may be the only opportunity to intercept this type of action that's going on outside of the hospital. And so, yeah, we want them to be proactive. We want them to be aware of this. So far, and I think most people are going to agree, this appears to be an overreach on behalf, and that's the understatement, right? It's an overreach on behalf of the hospital and the staff that was involved in Maya's case. And that's kind of where we stand.

There is a line there. There is a boundary where, yes, you have to note these. I don't even have a problem with them noting these things, informing DCF, covering their bases. But like you had just laid out, when they get the answers back from DCF and everything matches up, that's where it should have ended. We should not be still talking about this. So we don't want this to lead hospitals down the road, even with this case. And we're not going to say the results right now, but where this

ended up, we don't want them to turn a blind eye and we don't want them to be reclusive about this and not come out and say something when they see it and be hesitant to report these things because there's nothing wrong with reporting it. The problem is when you get the results of that report and you don't accept it because you don't agree with them. That's the issue here. And I think if I'm being fair and honest, I think Dr. Sally Smith started off as somebody who was just really passionate about protecting children. But when you make your- Admirable? Yes, of course. Right, obviously.

But when you make your whole life about finding and stopping child abuse, you might see it everywhere. You might see it even where it's not. And then what comes into play is confirmation bias, right? You get so set on protecting these children that you end up hurting them. And it looks like that's kind of what happened with Dr. Smith. Well, it's kind of the opposite of what I was referring to earlier with Kirkpatrick, right? He went into that, and it's a different reason, but he went into the diagnosis process of Maya of not saying she's got CRPS. I'm going to try to find the symptoms that support that. He wasn't working backwards. you're saying here with Dr. Sally Smith, allegedly, it appears that she went into it with like,

this child is being abused. Now I have to find the evidence to support it. So as the head of the Pinellas County Child Protection Team, Dr. Sally Smith examined virtually every child with suspicious injuries who visited All Children's Hospital. And it seemed that she was highly respected at that hospital. And her opinions on these cases were basically written in stone. Like the medical doctors and the nurses would go to her and they'd be like, what do you think about this? And she'd be like, this is what I think. And they'd be like, okay. And not only that, not just with the hospital staff, but with the district attorney's office who would prosecute some of these cases and with local law enforcement.

It was like Dr. Sally Smith was like big dick swinging out there. Like she walked in and everyone was like, oh, here's God. And I think this gave her this like inflated ego and almost like maybe took away her self-awareness to the point where she was like, well, everybody thinks I'm right all the time, so I must be right all the time. And it was a self-fulfilling prophecy of just being, you know, always in the right. And we're going to hear from her. And when you hear her testimony and the way she talks, you'll see what I mean. But since taking her position as the medical director of the Pinellas County Child Protection Team in 2002, Dr. Sally Smith had made a name for herself as being a passionate child advocate. But as USA Today reports, quote, as her reputation grew, Smith

also became known as a hardliner who sometimes crossed boundaries while interrogating families. In hospital lectures, Smith warned that parents and caretakers were often full-on lying. We have to ask a lot of questions to trip them up, she said at one presentation back in 2015. Most of the time, they've thought of the main lie, but they haven't thought of the details. So if you keep asking questions, the story falls apart, end quote. She sounds like a cop with tunnel vision, you know, and like in reality, like cops are usually interrogating and interviewing criminals and they would say some of the same things like, okay, this person's lying, but if we ask them enough questions and for long enough, we'll see that they're lying.

But these are parents and some of them are abusive, right? But a lot of them are not. So what you're doing is you're treating every single parent that is the parent of a suspected abuse case as a criminal. And you're not always going to get the best response from these parents. They may seem defensive. I mean, I would. I know I would.

I'd be like, what the hell are you doing, lady? Who are you asking? Who are you talking to like this? I would get defensive. And she's going to see that as, once again, confirmation of them being guilty, of them acting suspicious. Yeah, they're defensive because they're hiding something. They're defensive because they're hiding something.

Not that they're defensive that their child is sick and you're over here wasting their time with all of these questions that these parents would be like, she would ask the weirdest questions and they'd be super personal and super inappropriate sometimes. We don't know where this is even coming from. It's going to affect the relationship between Dr. Smith and the parents that she's talking to. And it's going to set them in like adversarial terms. Like they're not allies in this. They're against each other.

They're going to sense that she's an enemy. And so they're going to treat her as such. Smith is one of the most powerful figures in the child welfare system along Florida's Gulf Coast. And in Pinellas County, children are almost two and a half times more likely to be removed from their families than the state average. And there's multiple instances where Dr. Sally Smith got it wrong. Hundreds of Smith's cases have recently been reviewed because of this case, and it was found that there were more than a dozen instances where charges were dropped, parents were acquitted, or caregivers had credible claims of innocence, yet they suffered irredeemable damage to their lives and reputations. A Marine named John Stewart spent 300 days in jail after Smith alleged that he had killed his girlfriend's son by throwing him repeatedly against a soft surface, but the charges were dropped

when a neuropathologist contradicted Smith's findings. 39-year-old Tara Brown was accused of inflicting fractures to her six-week-old infant twins, who, by the way, she had trouble conceiving these babies. She had undergone like round after round of IVF, and then Dr. Smith is like, oh yeah, even though she went through all of that, which any woman who's done that knows it's torture. Even though she went through all of that, she's now going to have these babies to

completely abuse them. And so these charges were dropped when a doctor diagnosed the babies with a rare bone disorder. Brown remembered being under the scrutiny of Dr. Smith saying, quote, Sally Smith told me that if I didn't tell them what was wrong, then my children would be put in foster care. She looked us straight in the eye and said, one of you is lying. One of you abused your children, end quote. So the personal stories of parents who were thrown into a witch trial atmosphere at the simple word of Dr. Sally Smith, they go on and on. And now the Kowalskis would get to

see what that felt like firsthand. A nurse named Beatrice Teppa Sanchez reached out to Dr. Smith after DCF had closed their investigation the first time. And she told Smith that Beata Kowalski had requested Maya be given 1500 milligrams of ketamine and Beata was being pushy about it. You know, this nurse said. Tepe Sanchez also said that it seemed like Maya was better when her mother was not in the room. She would squirm and cry out in pain less. Dr. Smith was concerned to find that Maya had been receiving regular ketamine infusions, feeling this was potentially damaging treatment for a child. And on October 8th, using the All Children's Portal, Smith went

through Maya's medical records. Now listen, once again, since Dr. Sally Smith was not an actual employee of Johns Hopkins or Maya's treating pediatrician or treating doctor, this violated HIPAA. But she did it anyways. And the hospital obviously allowed her to do this, and this is going to come into play during the lawsuit. Dr. Smith also spoke to Maya and her parents, and Beata told Dr. Smith that things with Maya had been getting worse. Even the softest stimuli triggered her. She was unable to take a shower because the drops of water felt like fire hitting her skin. For the past three nights, Maya had only been sleeping for moments at a time. And in her report, Dr. Smith noted that Beata also talked about how she personally had been

suffering. She had not been able to sleep for weeks. And she mentioned how hard it was to work so much in order to maintain her insurance and to afford the ketamine and pain treatments. And Dr. Smith kind of made this seem like, oh, Beata was trying to get attention, trying to make it like, oh, poor me, poor me, make it about her, right? In her report, Dr. Smith wrote that Beata Kowalski seemed to have mental health issues. Now, where was the basis for this? Where was the basis for Dr. Smith to say, Beata Kowalski seems to have mental health issues? Had Beata been seen by- When did she get her degree in that? When did, well, yeah, exactly. When did she get her degree in that?

But not only that, did Beata have- Is she a psychologist, a psychiatrist? I didn't- She is not. You didn't read that on her resume. She's a child abuse specialist. Oh, okay. Just check.

I was just checking because- Did Beata have a history of mental health issues? A medical history of mental health issues? Nope. Did Dr. Sally Smith ask Jack Kowalski, Beata's husband, hey, has your wife been having some mental health issues? Nope. Did Beata get talked to by somebody in the hospital, a psychiatrist, psychologist, somebody in the hospital who then reported to Dr. Smith that she had some mental health issues. Doesn't appear that that happened either. So this was purely speculative on Dr. Smith's part. She put this in her report though. So it's interesting. Let's take a quick break. We'll be right back.

While going through Maya's medical records, Dr. Sally Smith was shocked to find that Maya had gone to Monterrey, Mexico the previous year to be put into a ketamine coma. This was a treatment recommended by Dr. Anthony Kirkpatrick, and the five-day procedure consisted of Maya being intubated and sedated while receiving high doses of ketamine, up to 50 times the usual dose. Maya would later say that she was scared as she was preparing for this procedure, but her mother was by her side the entire time, which made her feel brave. When Maya came out of the coma, she seemed much better, and she woke up and she expressed being hungry, which was a good sign because her appetite was something that, with the pain, was not present. It was not a strong appetite. Maya would later say, quote, the coma worked. The ketamine helped tremendously with my pain. I had a little bit of short-term memory loss and sometimes things were really blurry with my vision, but I was willing to have those side effects

if it was going to help me overall, end quote. After returning to Florida, Maya's headaches were much better. They were minor. Her pain at night was significantly better, and she was able to move her limbs without as much pain and effort. So obviously, I guess hearing that a 10-year-old went to Mexico to be put into a five-day ketamine coma would probably be shocking to a doctor. But once again, Dr. Sally Smith is going to speak to Maya's doctor. She's going to speak to Anthony Kirkpatrick. She's going to hear the reasoning and she's going to see that Maya's

symptoms were better and she's still going to have a problem with it. So as Dr. Sally Smith was conducting her own investigation that the Kowalskis were not even aware of, the hospital staff tried to buy her more time and another report was filed with DCF, but this time, more details were added. Details that lawyers for the Kowalski family claim were major exaggeration and even sometimes flat-out lies. A social worker reported medical abuse, claiming that Bieta Kowalski had suspected mental health issues, she was requesting her daughter to be placed in a coma using pain medications, and she had been giving Maya unauthorized IV meds at their home. The report also said that Maya was not actually in any pain, and when she'd voiced feeling

better, her mother had gotten angry with her. The report said that one day Maya had woken up and said she was hungry and she asked for a donut, but Beata had refused to give her a donut. And once again, like most of these claims are exaggerations. Beata was not giving Maya unauthorized IV meds at home. And Jack Kowalski would later say, yeah, like Maya did wake up asking for a donut one day, but Beata was at work. She wasn't even present when this happened. So this is a complete lie. On October 10th, the Kowalskis once again expressed their desire to discharge Maya from the hospital.

And at that point, they were told that if they did this, it would be against medical advice and they would be arrested. And this is very like annoying to hear because people check themselves out of the hospital against medical advice every day. I've done it multiple times. You know, you go in for something and then you realize like, oh my God, I'm going to be here for 15 hours. I haven't even seen a doctor yet. You know, I've been in the ER for 17 hours, not even seen a doctor yet. I can't even find a nurse. I'm just going to go and I'll come back tomorrow or whatever. I'll, I'll sew myself. Anything to not be in this ER one more minute.

And then they'll be like, well, you have to sign this form saying, you know, you're leaving against medical advice. And I'll be like, give me that form. I'll sign it. It happens all the time. You do not get arrested. It is not a crime. However, even though DCF had already told the hospital they had no legal basis to keep

Maya there, they ignored this and told the Kowalskis that they would be arrested. And here's Jack Kowalski explaining this and some other tactics that were used by the hospital and how he was feeling in this moment. Well, we wouldn't be able to leave without taking Maya. You know, they forced, or they stated that we'd be arrested. And so did it turn out then that you stayed with Maya that night at 79? Had no choice. And the next day was there a treatment planned to begin to complete Maya's course of the ketamine program treatment? Yeah she had a

scheduled appointment with Dr. Hanna in Clearwater. All right, and so there come a time when you met the doc, one of the doctors I mentioned in here, Dr. Sally Smith, and if you could tell the jury the situation and what you saw in first meeting Dr. Smith. The only time that i could recall meeting her was um i believe it was october 13th i was in maya's room she was getting a clean out for a procedure for upper lower gi where were you physically were you standing sitting i was taking care of maya she was constantly um had feces all over.

So I was trying to clean her, trying to take her to the little portable commode. Was she capable of doing that on her own? Absolutely not, no. Go ahead. There was a nurse in there, an elderly woman. She was assisting me, giving me new washcloths, things like that, sheets for the bed. Then all of a sudden, she walked out, and in walked this woman. It was a woman, black hair, cigarette voice.

And she didn't say anything. She's just looking at me while I'm overwhelmed, trying to clean up Maya. And she just started asking questions. And the questions really were kind of weird. During that time, it didn't pertain to what I was doing. She's looking around the room. Were there any introductions from the nurse? No, no, no introductions. And I thought it was kind of rude

because here I'm overwhelmed trying to take care of Maya. And there was no help. Was she wearing a Johns Hopkins? First, do you recognize what a Johns Hopkins All Children's Hospital lab coat? It's a lab coat. And do you recognize the little signature? They had the lab coat on, yes. Can you tell the jury whether she was wearing that at the time?

Yes, there was a lab coat. And what was your impression from the way that she was introduced or not introduced and wearing that lab coat and starting to ask you questions? What role did you think she was in at that point? She's a doctor or medical person within the hospital. And so what happened after that? You were... So it seemed like it was coordinated you know because when the nurse walked out, the doctor walked in, doctor left about 10 minutes, if that, and then in walked the nurse again. The nurse said, you have to leave your daughters under custody, protective custody. So from the time that you came in on the 7th through the 13th, did the state, to the best of your knowledge, or the hospital have any right to hold you there?

We have our right to go wherever we want. And did you reinforce over that stay that you wanted your daughter out of there? Many times. And what was the response when you would say, we're leaving, we're out of here? I think there was a stall tactic at one time. They gave Beata some hope and that never happened. But then if you leave, you're arrested. Did they talk about a transfer? We were talking about Nemours.

What was it presented to you well i i remember viado for the longest time wanted it as well and then i guess the hospital was also looking at nemours to transfer to uh the orlando area and why what was the reason you wanted other than just getting out of there, a transfer up to Nemours? They treat CRPS. And so then were you and Beata presented with a transfer form? Yes. And what was explained to you the reason would be why there would be a transfer to Nemours verbally? The reason was to go ahead and get her taken there and the problem was though we found out by looking at the insurance codes it wasn't for CRPS it was for Mauchausen by proxy.

So we did not sign that form because if we sign that form we're admitting admitting that we're. So the hospital did the hospital ever tell you that hey we're going to send you over there but we're going to start out with in their mind that there was child abuse going on no and the best of your knowledge dr. Dees was not a psychologist or psychiatrist that there was she I'm not aware of that and the best of your knowledge she never performed any type of psychological interview did she? Objectively. No she wasn't diagnosed with Mount Charleston. So this is on November 3rd this was the form can you tell the jury whether the events leading up to this form

began during this period of time that you were trying to leave between the 7th and the 13th? Yes it was. And was this the best best of your knowledge, the reason that they wanted you to continue to stay? Oh yeah, yeah we've been held there. And did they also attempt to tell you that your daughter had to be weaned off of medications? Yes that was like the first thing they stated. And did you inform them that at no time had your daughter ever exhibited any type of withdrawal symptoms? First, are you familiar with what withdrawal symptoms are? At no time we've seen withdrawal syndromes for every procedure she went through, including the one in Mexico that was the longest one.

And did you inform them of that, that there was no danger of that? We'd never seen anything. Notes from October 11th show that a nurse mentioned they were weaning Maya off the ketamine. And if this was not done properly, she said Maya could suffer from seizures, heart attacks, even death. And the Kowalski lawsuit states that this concern was unsupported by medical evidence because ketamine does not have physical withdrawal symptoms, unlike opioids. And Maya's last infusion had been four days prior. Now, that same day, Dr. Sally Smith called Dr. Anthony Kirkpatrick to discuss Maya's CRPS diagnosis, and she told him that the doctor treating Maya at ACH was concerned because Maya would recoil from the doctor's touch, but she seemed to be fine with the bedsheets

being on her skin. Dr. Kirkpatrick said this was a consistent reaction seen in some CRPS patients, and Kirkpatrick made his own notes during this call, and he wrote that Dr. Smith seemed very focused on proving that Maya was suffering from Munchausen by proxy. Realizing this, Kirkpatrick cautioned Smith against accusing the family of abuse, because patients with neurological disorders like CRPS are often told it's all in their heads or they're making up their symptoms, which leads to them not getting the care that they need. Accusing Maya's parents of fabricating her condition would not only cause this, but also lead to the Kowalskis undergoing unnecessary stress when they were already struggling with so much. Despite this, and despite speaking to Maya's other doctors who also confirmed her diagnosis and treatment plan, Dr. Sally Smith put together a preliminary report claiming that Maya did not meet the criteria for CRPS and that she was likely suffering from Munchausen by proxy.

And does everyone pretty much knows what Munchausen by proxy is, right? Because we've all heard about the gypsy rose. I was just going to ask you that. I mean, I know what it is, but maybe what's the 32nd version of Munchausen syndrome? Basically, it's like I have a child and I make her sick or pretend she is sick so that I get attention. So everybody's like, oh my God, what a great mother you are. Oh, this is so hard for you. So it gets me attention by proxy, right? I'm making my child sick so that I get attention, so that I get praise and approval and external validation. They could literally, parents will literally give their kids certain items to make them physically sick and ill over a period of time. It may be small doses of something that's going to keep them consistently ill without really the child knowing that they're

feeding them. They could put in their food, but they're feeding them something that's deliberately making them sick. But yeah, I think most people know, but there's probably some people out there, I first learned about it from Eminem in a rap song. I'm not joking. But anyways. Eminem, Marshall Mathers teaching us all. There you go. So this does happen. It's a real concern. And it's terrible. I couldn't even imagine doing this to a child. I couldn't imagine doing this to my child. But this does happen. So it's understandable that Dr. Sally Smith would entertain the possibility. But when she's heard from multiple doctors, yes, this child has CRPS. And then she

writes in a report, Maya does not meet the criteria for CRPS. In fact, this is what she has instead. That's a concern because you're completely ignoring the people who are trained to recognize this disorder. And you are not familiar with this disorder at all and clearly didn't even do your research about it. Well, at least it wasn't as far of a reach as diagnosing Bieta with the medical condition without even having a background in that field. It's pretty much the same amount of reach, I feel.

I'm being sarcastic here, but yeah, you know what I mean? At least that's her field that she's in, where that's her job. But yes, like you said, someone whose specialty is CRPS, that's obviously going to be someone who should be determining whether or not. And on October 14th, the dependency shelter order designated the hospital as the shelter location for Maya, basically saying like her parents could not take her out of the hospital. for her CRPS for the last year. They did not mention that they'd installed a port to help with her ketamine infusions or that they had provided Maya with prescriptions for ketamine and other pain medications for CRPS. They also did not tell the court that multiple CRPS specialists who had been seeing Maya for an extended period of time had diagnosed her with that condition. And of course, this was not included in Dr. Sally Smith's report. So now we're going to hear from Sally Smith defending her actions

and defending the omission of this information during a heated testimony for the Kowalski lawsuit. And pay attention to what this woman says, how she says it. And if you're watching on video, look at her facial expressions as she's being questioned by the lawyers. Before, or let's say right at the start of this in the first part of October, you had a call with Dr. Kirkpatrick, did you not? I did. Dr. Kirkpatrick explained to you that he had been treating Maya Kowalski for CRPS, correct? He did. And he told you that statistically speaking, CRPS is often mistaken for conversion or Munchausen by proxy, did he not? I don't really remember exactly what his words were. I took a few notes from the conversation that I had with him, and I know that there was some general discussion along those lines. And yet you did not put anything

in your report about Dr. Kirkpatrick, did you? Yes, I believe there's a whole section about his medical records. Yeah, except for the fact that you did not tell anyone in that report that he had warned you off of going after the Kowalskis. That's, it's completely irrelevant for a child protection team medical evaluation because that's the whole point of the of the evaluation and gathering all the records the problem in these cases is that the treating physicians have not done that and so the fact that he who sent her to Mexico for the ketamine coma told me not to investigate child abuse it was completely irrelevant to me because the my job was to investigate child abuse so if I had

come away from my job saying I was supposed to do this but this doctor told me not to so I'm not doing it and there's no evidence of anything here I would not have been doing my job even remotely near a standard of care do you not understand the importance of putting both sides of the story in your report? The both sides of the story is the responsibility of the various people who are going to present it to the court. My job as the medical director for the child protection team is to do what I need to do to assist the investigators and the detectives and the attorneys that are involved in the case as to whether there is evidence to support a diagnosis of whatever type of child abuse is being assessed so it's

not my responsibility to lay out some whole long argument about what it might be otherwise if I had extensive evidence to support that it's a type of child abuse dr. Smith you know there wasn't a single child psychologist or child psychiatrist that diagnosed what you were claiming you're aware of that right that's also irrelevant so you are the ultimate decider of medical issues which you have minimal or no training in I have extensive training yes but that's a proper you can answer dr. Smith I have extensive training in evaluating child abuse and neglect medical child abuse is a child abuse pediatric diagnosis there

is a parallel track in psychiatry where there's a thing called factitious disorder imposed on another, which is assessing the perpetrator or the caretaker in that scenario. But I don't need a psychiatric degree to assess medical child abuse. I'm very well trained to evaluate medical child abuse based on my child abuse pediatrics experience and board certification. Well, there's not a single child psychologist or psychiatrist that agreed with you. You do realize that, don't you? No, I don't. Well, name a child psychologist or psychiatrist that examined Maya Kowalski who agrees with you? Well that wasn't their job to write in the report whether there's medical child abuse so

that specific thing documented by for example Dr. Cabot or Dr. Katzenstein I don't I don't know honestly I'd have to look back to see if they ever documented that as one of their diagnoses. But that's not their job. My job is to assess that, and if I present adequate evidence to the court, the court can act on that. So the court has every ability to pull all these people in, including Dr. Kirkpatrick, including Dr. Hanna. I think they testified in the in the dependency action and and if the judge decides that there's serious question about whether I'm right then you know the court makes that decision based on the evidence that they receive that's not my job to litigate the whole thing and put out all of the potential possibilities in the case and say I'm the child abuse pediatrician but

I don't really know if there was child abuse here because in this case they're clearly in my opinion was child abuse here yeah so you did not put in any of the conclusions or any of the data from Eagles wings and those therapists and psychologists that saw the Kowalski's did you there was a licensed clinical social work intern who saw Maya and her family at Eagle's Wings and I don't honestly know where that was in the pile of records when I was writing up my report I kept writing part of the report having to do other things writing part of the report having to do other things, and I inadvertently did not include that in my report.

Well, you did research it enough to realize that Rebecca Johnson had a master's degree and over 20 years of experience as a therapist at Eagle's Wings. Did you not? Well, the question really in terms of my part is whether- I'm just asking you if you knew that or not, ma'am. I knew she had she I'd have to look and see exactly what her credentials were I'd certainly you know defer to you if you're reading her credentials off but it's irrelevant unless she did the whole thing I did looking at

all these medical records and has expertise in medical child abuse for her to be able to say one way or the other if there was child abuse or not. Okay. Look, did anybody agree with your assessment that there was no CRPS? Yes, I believe they did. Who? I believe that there were multiple people in the hospitalist team that didn't think she had it, and I believe that although there was probably some question about whether she might have some sort of amplified pain disorder the pain management team didn't think she had CRPS well amazingly

enough we did have dr. Elliott in here to testify and he never said that she did not have it none of the doctors so far testified a that they were experts in CRPS or B that she did not have it are you aware of that no I'm not I wasn't supposed to watch any of the testimonies I had no idea what people talked about from your investigation though at the time did it come to your attention nowhere in any of the records did anyone who had any expertise in this that is a pain management doctor a neurologist or an anesthesiologist, ever agree with your assessment that there was no CRPS?

I think I just answered that. Yes, I believe there were people that had the same opinion. Okay. What did you check with Dr. Spiegel, a board-certified neurologist that treated Maya and confirmed CRPS? Dr. Dr. Spiegel had this 10-year-old child do hyperbaric oxygen treatment, I believe on 40 occasions in a row when she also got ketamine on some of the same days so I wasn't terribly worried about whether he thought or did not think that she had CRPS because you'd already decided in your mind that a board-certified pediatrician with his years of experience was not qualified to render an appearance an opinion on that is that right I'm sorry dr. Barr yeah a board-certified

neurologist he testified and confirmed CRPS did you put that in your report I don't know that I specifically said that he said that diagnosis. I think, as I recall, without going into the stack, that I did say in the history that Dr. Kirkpatrick had diagnosed her with that. Those people might have had that opinion. I don't think, based on my review of the CRPS literature and discussions with physicians since then, and in the context of all the evidence that there was a medical child abuse, that Dr. Barr's opinion, if that was his, that she had CRPS was reliable. Okay, so now Dr. Spiegel is not reliable and he's a neurologist. At least will you agree that neurology and anesthesiology are the two areas that are most involved in

investigation of complex regional pain syndrome? I imagine those are people that typically evaluate and treat patients with complex regional pain syndrome, sure, but not all neurologists and pain management or anesthesia, I'm sorry, not all neurologists or anesthesiologists are, if you will, it equally there are some who practice at a very high level and when I having reviewed medical records from all kinds of providers all over the state and even other parts of the country for 35 years read through information and see all the supporting information that they have and compare that with other information that I gather in my medical record review. I can assess whether the person

That you know made thousands of dollars was reliable or not And I didn't find those people to be particularly reliable in terms of their diagnosis Even though I certainly included their information in my report Dr. Hanna, an anesthesiologist with over 25 years of experience in treating CRPS, you didn't put his confirmation, or excuse me, he did a diagnosis of CRPS in your report either, did you? I believe in the history. I made reference to that. Yeah, I'm pretty sure I did say that that he you know made that diagnosis but this is a doctor who was giving a child a 10 year old child who's on the small side a thousand milligrams of ketamine

anywhere between 8 and 32 milligrams of Versed doses of Zofran, doses of 1750 mg typically of Magnesium, all at the same time in an outpatient setting with no documentation of vital signs, and there was indication in the records that appeared to me to suggest that the family member was the person monitoring the pulse oximeter. So that person, to to me is not particularly reliable in terms of whether this child needed the treatment that she was getting whether he made an accurate diagnosis or not so I put his information in my report yes I discounted his diagnosis and of course

you discounted dr. Cantu's confirmation of CRPS. Well, I never got any records from Dr. Cantu, so I couldn't really address that whole situation other than from the WordPress blog. This person put a 9-year-old child in a ketamine coma for days. It took her probably about a week to just be able to be discharged from the hospital after that. I didn't find him reliable from what I saw. All right. So if I'm understanding you, the fact that three different treating anesthesiologists specializing in CRPS, two different neurologists specializing the treating of

CRPS, you know more. Fair? I don't know more. As I said, I looked at their information and based on what was done with this particular child, I did not find their opinion to be reliable. And who elected you to be the judge of whether all of these board-certified physicians were reliable nobody I presented it to a real judge who made a determination well isn't it true ma'am that you are not a medical investigator you are in fact a medical prosecutor. That's absolute nonsense. Because an investigator would include both sides of the story and let the judge decide, right? No. The child protection team medical director will assess

whether there's medical evidence to support a diagnosis of child abuse and then the dependency attorney will present that to the judge and the other side gets attorneys also there were five in this case and they present all the information and then the judge tries to decide you know what who's whose information is more reliable. Here under oath, are you telling us, are you an investigator or are you a prosecutor? I am neither. I'm a medical doctor who is an expert in child abuse pediatrics.

Okay, we are back. That was an interesting interaction back and forth. I have so much to say, but for the sake of expedience, I'll try to keep he even said this line, was she's acting as a prosecutor. And I wrote this phrase and I want to break that down more and look at this from a criminal standpoint. Okay. Because she is acting as a prosecutor here. And to just to quote the lawyer, he said, you're not an investigator, you're a prosecutor. So I circled that like 17 times, but let's put it in that context because she is without a doubt acting as a prosecutor. There's no doubt about this, right? She's not acting as an independent investigator, giving both sides of the story and then allowing a judge to make the ultimate review. She's presenting a case against the family. That's

at least the way she's presenting it here. So with that, because she is, in fact, acting as a prosecutor, we talked about the Sinad 9 Syed's case, right? The prosecutor has an obligation to present, obviously, inculpatory evidence, but also potential exculpatory evidence, right? And not doing so would be classified or could be deemed a Brady violation, right? So regardless of whether she feels the input of certain doctors is viable or credible or not, it is her responsibility to turn that over so that the person making the determination has all the facts in front of him or her. That was her biggest misstep was being the gatekeeper, right? I think he even said that

being the gatekeeper and determining who is credible and who is not, that is not her job. Her job is to look at the evidence, right? Document that evidence for as a medical professional based on her 35 years of experience, give her opinion based on her assessment, but also include dissenting opinions from other medical doctors. Some who may argue are more qualified than her to not maybe determine whether Maya was being abused, but to determine if Maya was suffering from CRPS. That's the big issue here. She basically just gave her decision, her investigation, her report based on what she felt would support her analysis and kind of, if at all, just made a side note about what these other doctors and their dissenting opinions thought.

But that was really my big takeaway. I will say this, and she said it and I'm just repeating her, I'm using her own words. And this is true. Just like in the profession when I worked at IA cases, not all police officers, as we know, are created equal, right? There's this joke about doctors, right? A doctor who, what do they call a med student that graduated with A's and a med student that graduated with C's? Doctor. They're both a doctor, right?

That is true. So I understand where she's coming from, where there are doctors out there who are morons, right? And maybe their practices are unorthodox and even in some cases dangerous, right? So that is, I think it's important for her to look at it and go, just because he's a doctor doesn't mean he knows everything. Well, that falls under for you too, Mrs. Smith, Dr. Smith. My final takeaway, and this is the, I just went in on her, but let me just give another side to this, okay? She's very confrontational during this. Understandably, I get it because she's someone for 35 years who basically was judge and jury. And now she has people questioning her competency and her ability to perform her duties. And I've been under this

situation as well, where I've had defense attorneys and different individuals in that capacity question my work, question my credibility, question my integrity. And it's human nature to be confrontational and defensive in certain situations. It's happened to me. It's happened to a lot of people. But I just want to say this one thing about Dr. Smith. Obviously, I don't agree with anything she's saying here. And I don't think most people will. But I do just want to throw this one thing out there.

I think what she does for intent versus action, right? They're two different things. I think her intent overall is to make sure that these kids are not being hurt at home. That's her intent. I think that's why she got into this position. And I think maybe even initially, and you might've already said this, that was her intent in Maya's case. But there was something that happened along the way where it became less about finding out what happened and more about proving what she believed. And that can happen to even good doctors and people with good intentions at first. So I'm not going to sit here and say that this woman is a criminal

and she should be in prison. Obviously, again, she's done some really not, this lawyer pointed out just some things that sound really stupid when he put it all into one narrative. Basically, you discredited all these doctors in these fields who are more qualified than you. But I just want to put it out there that I don't think this woman had been doing this for 35 years because she was out to just arrest parents all over the country. And I know that maybe not even anybody suggesting that, but I just wanted to throw it out there. But overall, this did not look good for her.

And it really didn't make sense to even a dummy like me, who's not a doctor, where I'm just like, you're a doctor, you're assessing this woman, this kid, this child, you're a specialist in this one specific area, child abuse. These other doctors are specialists in areas that you're not a specialist in. And you're telling them that their assessment of that specific issue that they are experts in,

that they're wrong. And it just not one doctor, not two, not three. Would they mention five? I know I went, thank you for allowing me to go on my tangent. Multiple doctors. That's the problem, right? And the fact that she didn't document it is the bigger issue. Not that she didn't agree with them, but the fact that she chose to, let's just say, omit a lot of their analysis where she could have included it and then still included the dissenting paragraph saying, although Dr. So-and-so said this, this is why I disagree with them. Although the doctor, this one said this, I disagree with him. And you can let the judge

decide out of those two statements who is more accurate. And I know those doctors got to, I believe, come in and give their assessments and their depositions as well. But once she's going forward with all of this and not including it initially, it's kind of stacking the deck. It's kind of stacking the deck. So that was my takeaway. And remember, I said how respected she was, right? Like her word i get it was gold carried a lot of weight and she's a doctor so the judge is gonna hear like okay she's a doctor i trust her i've encountered her multiple times she's reliable and she doesn't believe these other doctors and these other doctors could be quacks and like the whole ketamine thing and And it sounds valid, but she kept saying that's completely irrelevant.

That's completely irrelevant because she didn't agree with the methods and the treatments that these other doctors had decided on. She decided it was irrelevant not to be included. And that's why he says like, what are you, judge and jury for what's relevant and what needs to be included? It's ridiculous. It seemed that Sally Smith, although she could put the legwork into reading the records that she wasn't even supposed to have access to and speaking to some of the medical professionals

who treated and worked with Maya, she just didn't find any of them to be credible. And although she was not trained or knowledgeable on CRPS, she still felt that her opinion and instincts were more reliable than anyone else's. This is an issue. This is why I say there's a big factor of ego here. I'm right. I'm the final say. My gut instinct is more important than these people's, because they've had decades of experience in their fields as well, right? So she's getting defensive because she's being questioned. She's been doing this for 35 years.

But Dr. Kirkpatrick's been treating CRPS patients for decades as well. So why do you deserve respect, but you can't give it to another physician? It's very like short-sighted. It's hypocritical. And it seemed that Dr. Smith's tunnel vision on seeing abuse in Maya's case led to Maya being forced to remain at the hospital. It eventually led to Maya being separated from her parents with the hospital staff being in complete control of who she saw, who she spoke to, what she did,

and how she was treated, which is now going to lead to more issues and more allegations from the Kowalskis. Because while Maya was trapped at All Children's Hospital for 87 days, some things did happen to her at the hands of the doctors, nurses, and social workers employed at the hospital, which led to further pain and trauma to a child who'd already been living in her own personal hell. And then on top of that, she leaves and her mother's dead. Yeah. Yeah. I can see why this case is so polarizing and why it was covered by Netflix and why it's basically the national talk right now. Everyone's talking about it on social media. And I think

that's why we decided to cover it because you get the surface level stuff. I'm just hearing about this case now. And I wanted, I think a lot of people to learn more about it and to understand what really happened here. I don't want to give too much away. I think a lot of people, there's a lawsuit going on. There was a lawsuit going on. There was a settlement. I don't want to spoil anything here. You can go look it up, but it's crazy what the things that are getting thrown out there as far as numbers. And you wonder, wow, how bad was this really? And instead of looking it up, I wanted to cover it with you. And so that everyone else could cover it, talk about it with us and understand the specifics in the timeline of what actually happened here. And I leave this episode

extremely frustrated that we're here knowing the outcome and knowing that regardless of settlements and all these other things, they're not going to bring back Pieta. And Maya and Kyle are never going to see their mother again. So I'm glad we're covering it. I know, what are you thinking here? One or two more parts? Probably two more parts, yeah. Because there's a lot to go over. But I also want to say, the Kowalskis had more than one lawsuit. And I believe, I believe, I'm not 100% correct,

but I believe by the time Dr. Sally Smith is testifying here, she's already settled with the family. Yeah, that was like 2.5 million. I believe there's another one for 2.5 million when I was just looking it up. We were taking a break. I was trying to look up Dr. Sally Smith. I think it was for 2.5 million. I believe there's another one for 2.5 million when I was just looking it up. We were taking a break. I was trying to look up Dr. Sally Smith. I think it was for 2.5 million.

She's already settled and she's still defending her actions. And the hospital, even after all of this, is still like, well, we just believe her still. We trust her. And it's one of those things where, again, you're closing ranks and you're dying on the hill that you should not die on at this point. But there's a lot at stake, so they don't want to admit fault, which is understandable. A lot of money. But it's going to come out that there's a whole bunch of other stuff. And we're going to talk about the defense and what they claim. We're not going to be one-sided here. We're not going to be

biased, even though I clearly believe that there was tons of wrongdoing on behalf of Dr. Sally Smith and Johns Hopkins. But we're going to discuss what their defense is, what they say, what they claim happened, why they did what they did. So we're going to look at both sides. I definitely, that's what we're supposed to do, right? Yeah, unlike Dr. Sally Smith. Dr. Smith. Yeah, look at both sides and let you guys kind of decide but uh but yeah please weigh down in the comments on this one this is a crazy one we have a lot of footage in here which is always great because you get to really see it with your own eyes and hear it with your own ears but let us

know what you think about this one um share your opinions on this case are there some of you out there which I'm sure there are, that may not necessarily disagree with Dr. Smith? And we want that. We want to have that amicable, constructive debate in the comments. We don't want anyone taking potshots. But overall, I'm glad we're covering it. I know way more about this case than I knew two hours ago. It's so funny with us. We always say, this is going to be probably a quick one tonight. And it probably could be if we just stuck to the script, but we care about this stuff because we are parents and this could happen to you. It could happen to me. So it's important to really break it down because we can't change

the outcome of this case, but maybe it might be something that we can prevent for someone else or even ourselves in the future. And that's why I always say it. It's important to be educated. It's important to be informed because then you're better prepared for a situation like this. So that's why we do it. It's unfortunate that we have to be, but it's the reality we live in. Absolutely.

And it could happen to any one of us. It absolutely could. And it's just a, it's kind of ironic that Bieda left communist Poland because of how much, you know, how much power the state exerted on its people only to find herself in a similar situation of being powerless. Fighting to see her own daughter. Yeah. Crazy. All right. So we're going to wrap this one up. We appreciate you guys

being here. As I said at the top of the show, if you're listening to this, why are you not sleeping first off? But if you are not sleeping and you're going to be up all day and you have some free time, we would really, really appreciate it. If you joined us at 2 PM today, if you're listening on audio for the Preble Penny Conference out of Ohio. We will be streaming it live. It's a big day for us. We're really excited about this because, again, this was something that we kind of thought of. This was our purpose. This was our goal over a year ago. And now this is the first case of it being realized. And it wouldn't be without each and every one of you who have contributed to Criminal Coffee, who've purchased a bag, a box of K-Cups, this is something, a win for all of us.

So we'd really like you to be there and share in this moment to hear this news. We will be there. We hope you will as well. Everyone stay safe out there. And if you're going to join us, we'll see you in a couple hours. But if not, we'll see you next week. Bye.