Nobody Should Believe Me - The Human Cost of “The Preventionist” with Dr. Sally Smith

Episode Date: November 27, 2025

In this episode, Dr. Sally Smith is back on the mic to share her reaction to the recent appellate ruling that overturned the massive judgment against Johns Hopkins All Children’s Hospital in the Maya Kowalski case. She talks about what the decision means for mandatory reporters, why she sees it as vindication of her work, and what it’s been like to be cast as a media villain simply for following the evidence. Andrea and Dr. Smith also discuss The Preventionist and reporter Dyan Neary’s portrayal of Dr. Debra Jenssen, and why these narratives about “overzealous” child abuse pediatricians can so easily miss the reality of how these cases are actually evaluated. Dr. Smith offers context on the medical processes involved and what’s at stake when public conversations lose sight of the vulnerable children at the center of these stories. *** Try out Andrea’s Podcaster Coaching App: https://studio.com/apps/andrea/podcaster Tickets for Nobody Should Believe Me LIVE: https://www.andreadunlop.net/nobody-should-believe-me-live Order Andrea’s book The Mother Next Door: Medicine, Deception, and Munchausen by Proxy.  Click here to view our sponsors. Remember that using our codes helps advertisers know you’re listening and helps us keep making the show!   Subscribe on YouTube where we have full episodes and lots of bonus content.  Follow Andrea on Instagram: @andreadunlop Buy Andrea's books here.  For more information and resources on Munchausen by Proxy, please visit MunchausenSupport.com The American Professional Society on the Abuse of Children’s MBP Practice Guidelines can be downloaded here. Learn more about your ad choices. Visit podcastchoices.com/adchoices

True Story Media I wanted to let you know about a really exciting new app called Podcaster Pro that I created in partnership with the awesome immersive online teaching platform Studio.com. If you are thinking about starting a podcast in the new year or if you have a show that you would like to grow and monetize, my new app with Studio can help you do all of that. I have learned so much in the last several years of making nobody should believe me. So I was very excited when studio approached me about this collaboration because I'd really been wanting to share everything that I'd learned about both the creative and business sides of

podcasting with other creators. And this has just truly been the coolest way to do that. So this app is more than just a series of lessons. It will help you come up with a great show concept and format, give you guided lessons to help you learn the editorial process of making the show. and it gives you feedback on drafts of everything from your episode outlines to your audio drafts, your marketing plans, and more. Another cool thing about this app is that it meets you wherever you are and everything is 100% personalized to you and your goals. I put so much work

into building this and I think you'll love it. We have just launched this app and Studio is offering a special introductory rate through Friday, November 28th only. So if you've got big plans in podcasting in 2026, now is the time to sign up. You can head to studio.com slash Andrea. That's studio.com slash A-N-D-R-E-A for more. And we will have that link in the show notes. Happy podcasting. Hey, it's Andrea. It's come to my attention that some of you have been served programmatic ads for ICE on my show. Now, podcasters don't get a lot of control over which individual ads play and for whom on our shows. But please know that we are trying everything we can to get rid of these by tightening our filters. And if you do continue to hear them, please

do let us know. In the meantime, I want it to be known that I do not support ICE. I am the daughter of an immigrant. I stand with immigrants. Immigrants make this country great. It's been an interesting couple of months over here, nobody should believe me. After season six aired, a case that we're still very much following, I wasn't quite sure where to go next. The Colin McDaniels story took a lot out of all of us, and as much as I love making this show, it can be emotionally grueling. And there are, unfortunately, no shortage of cases I could dive into at any given moment with multiple high-profile lawsuits around the country and my inbox piling up with bizarre and horrific stories. People frequently ask me how I find the stories

on the show, but the reality is at this point, they mostly find me. And lately, with everything happening, we've felt like a mini newsroom over here. And several of the stories in the headlines have brought us back to a familiar voice. I am a pediatrician and also a board-certified child abuse pediatrician. And I was essentially accused of all kinds of things in evaluating Maya Kowalski for allegations of child abuse. In her case, it was medical child abuse or Munchausen syndrome by proxy. Maya happened to get admitted to Johns Hopkins All Children's Hospital in October of 2016. And I did a medical evaluation for her under the Child Protection Team.

Dr. Sally Smith has been villainized in a torrent of media coverage over the past several years. Most notably, in the Netflix film Take Care of Maya, which was viewed by millions of people. We've stayed in touch since I first interviewed Sally two years ago. And we've been back on the mic with her for our new season. So naturally, I wanted to hear how she's feeling in the wake of recent events. Decisions were made in court that resulted in an enormous finding of financial liability for Johns Hopkins All Children's Hospital. And they appealed it on multiple grounds. And they just won their appeal.

And it was very helpful in terms of reinforcing. that people who are trying to keep children safe and evaluate them for possible child abuse and neglect, not only in Florida, but across the country, are protected from liability as long as they're acting in good faith. And the appeals court essentially found that both Johns Hopkins All Children's Hospital and I were acting under our responsibilities under Florida statute regarding a child where there was serious concern for child abuse, and that we can't be held to some $200-plus million, you know, judgment over essentially everybody doing their job and following the orders of the dependency court in the case.

Yeah, I mean, so we had Ethan Shapiro on, and he talked us through, this verdict, and it was quite a strong opinion that the three justices wrote from the appellate court. And really, the essence of it was not only reversing the verdict, but saying that this should never have gone to trial. And that the reason that this went to trial was because of an error, a series of errors on behalf of the series of errors. Yeah, a series of errors on of the trial court and Judge Carroll that misinterpreted the law. So this was quite a strong ruling in terms of, again, yes, upholding mandatory reporting laws and protections for people who are participating in the system that they are legally required to participate in. You know, so before we

get into kind of what this, what this verdict means and how it can, how it could possibly sort of affect the mood in terms of doctors who are tasked with this duty of care. How did you feel when you heard this news? I felt like it was pretty strong vindication regarding personally my role in the case where I don't know that it's ever been put into public record, but I reviewed thousands and thousands and thousands of pages of documents about this child and ended up producing a 45-page report delineating all of the different ways that there was evidence of medical child abuse in the case. And somehow I can get sued for saying that, doing my job.

And then the other thing that I thought was really striking in the trial was there was a lot of testimony, including a quote-unquote expert, Dr. Eli Newberger, who has since died, talking about, you know, essentially gross malpractice on my part and no idea what I'm talking about, about medical child abuse and, you know, totally assassinating my character and everything, all that was presented to the jury during the plaintiff's side of the case. And then when Johns Hopkins, All Children's, is trying to present their defense to the jury, the judge somehow determined that none of the information about the actual child abuse case was relevant in the jury's decision making, which at the time, I mean, I was just dumbfounded. I couldn't understand how that was

possible that that was a judge's decision. And, you know, I didn't see any way. And as it turned out, it played out in that manner that there could be some kind of fair assessment of all the information in the case under the trial circumstances. And I honestly wasn't terribly surprised by the verdict because of these errors that were made by the judge. And the appeals court delineated those pretty clearly that there was a lot of information that was presented to the jury that should never have been presented and was inflammatory and, you know, sort of directed them down this path of some kind of egregious behavior and, you know, things beyond the pale of society and things.

And, I mean, it was absolutely ridiculous in my view. So I was pretty happy that the appeals court agreed that that was the case. Your former employer Suncoast had actually already settled out of court with the Kowalskis. And now hospitals and other entities, other businesses, settling lawsuits, you know, is pretty routine because it can be, you know, a way to save military. millions of dollars otherwise that could be spent in court. However, I think it's really important for listeners to know that that was not a decision that you made, personally, to settle with those. Absolutely not. And it wasn't one that you wanted. Yeah. I almost refused to sign it. But I didn't think I had essentially the legal standing to do that. If you want the full scoop on

what happened with Maya Kowalski, you can listen to the Jillian episodes I did on it in our third season. But importantly for this conversation, the thousands of pages of court records from the lawsuit show an escalating pattern of medical child abuse. This culminated with Biotta Kowalski demanding that Johns Hopkins All Children's give her daughter a massive amount of ketamine, and when they refused, threatening to take her home and put her on hospice so she could finally die. Beata, who was an infusion nurse, who had previously administered ketamine and other drugs to her daughter through her central line, threatened.

to just give her the ketamine herself if the hospital wouldn't. There is exhaustive evidence of Maya's abuse and the threat her mother posed to her, but you'd never know any of that from the media coverage of the case. Because in another intriguing point of connection, before the preventionist turned its sights on Dr. Deborah Jensen, Sally was the first doctor to get Diane Neeried. And I think actually the title of Diane Neary's piece, as it aired in New York Magazine,

and this is with the caveat that editors might have chosen this for her, but it certainly, I think, encapsulates what's in the piece. The title that it was, this piece was published under was, was what happened to Maya Kowalski? When a 10-year-old girl complained of mysterious pain, a doctor suspected child abuse, how far would she go to prove it? She would review all the child's records

and see if there was evidence of child abuse and then, you know, assess that. That would be what she would do. Yeah, she would do her job. And, you know, I believe very strongly, after having, again, spent so much time reviewing all the documentation, watching every minute of the trial, I really strongly believe that if it was not for your intervention and the intervention of the other doctors at Johns Hopkins, the Maya Kowalski would not be here. I think that's a reasonable concern, for sure. In addition to the idea of the hospice thing and continuing to give her Ivy Cadmine at home and things like that, another option was they were going to take her to Italy where some other experimental treatment was going to be given. So, you know, I mean, obviously your listeners are very familiar with a lot of these kinds of features of Munchausen syndrome by proxy, medical child abuse.

And so there were numerous ways in which the child's safety. was seriously at risk if she was allowed to have her mother continue to make her medical decisions. I was reading this morning in thinking about this whole situation and Diane Neri and her reporting on you and her reporting now that's coming out about Dr. Debra Jensen. And I was remembering that you had sent me your exchange with the fact checker. from New York Magazine. And there are no fewer than 30 points that you attempted to correct for the fact checker.

Very few of those corrections made it into the final piece. Right. But I really found what you said at the outset of your email to the fact checker, who you're communicating with, affecting. And I wondered if you could read what you said. said at the outset of this email about your work and your history? I do recall writing this. So I retired from Suncoast, the company that held the Child Protection Team contract at the time, and the Child Protection Team in July 2022, after serving

the children in my community for 32 years. Over those 32 years, I was on call for children admitted to Johns Hopkins All Children's Hospital 24-7-365 unless I was out of the country and provided thousands of medical evaluations for children with allegations of child abuse and or neglect. I saw dozens of children who are literally beaten to death. I saw hundreds of babies and children who were killed or maimed by abusive head trauma. I saw hundreds more babies and children who had multiple broken bones from abuse, including young infants with more than 20 fractures in different stages of healing. I saw numerous children with ruptured intestines and internal organs from abusive abdominal trauma, some of whom died. As difficult as it may have been to see so many

abused and neglected children over so many years, other factors prompted my retirement, including repeated unfair, biased, slanted media reports, social media campaigns that resulted in thousands of threatening obscenity-laced calls to the staff of my private pediatric practice, dozens of calls to my personal phone, threatening to kill me and burn down my house, and ongoing attacks on my emotional health and personal safety. Responding to biased media reports has been impossible because I'm ethically bound to protect and respect the privacy of the children for whom I have provided CPT medical evaluations. So I cannot give details regarding cases that would effectively counter much of the erroneous

information that's been published about me and other child abuse pediatricians. I am so bound regardless of whether parents or attorneys or journalists have chosen to breach the children's confidentiality. Therefore, I have attempted to respond to the numerous inaccuracies in your email as best I can. Yeah, and, you know, the reason that that struck me, number one, you know, I think there have been over the past several years this series of attacks on child abuse

pediatricians. And I will say like I listened to an interview with Gregory Anderson who was the former lead attorney for the Kowalskys. He has been fired by the Kualskees, but he was

opining on the court decision. And he said something and I am paraphrasing here. He disagreed with the appellate decision not surprisingly, you know, but also said something to the tune of that he believes that these laws that protect mandatory reporters aren't good laws. I do think that there are people out there that really just don't support mandatory reporting and don't support protections

for mandatory reporters. And I think that that tends to be in a lot of media, the quiet part that's not being said out loud. And I really think that this media coverage of child abuse pediatricians can best be understood as part of a campaign to overturn those laws. On behalf of people that do not think that parents' rights should be infringed upon and really don't believe that children should have sort of individual rights that should be, you know, protected by others in the community besides their parents.

But I just, as a person who covers exclusively child abuse cases on my show, I feel like I really do understand the stakes. And I understand the stakes both ways, right? I understand, like, I think about all the time the unintended consequences that could happen of my reporting. Could this make the situation for the children worse in some way that I'm not anticipating? Could this make life harder, you know, something that I've thought about so much in my reporting. Could this accidentally make life harder for parents that have legitimately sick children, right?

Could this throw suspicion on these legitimate conditions, however rare, you know, that could this throw suspicion on legitimate cases? And now I try very hard to make sure that those things don't happen. And I've gotten a lot of really wonderful feedback from, you know, parents who have sick children over the years that that's, you know, that it's actually helped them not be afraid of doctors because I realized that, you know, these. And I think that's another unintended consequence, right, is just making communities afraid of the children's hospital. Do you think communities should be afraid of children's hospitals? There's all kinds of flames being fanned as if, you know, going to whatever, a Lehigh Valley facility is going to result in everyone having their children removed. I mean,

it's ridiculous. Yeah. So in terms of the preventionist, you've listened to it. I have. What are, well, first of all, do you know, I know you both worked in Florida for a while. Do you know, do you know Dr. Debra Jensen? I do. Okay. She is an outstanding child abuse pediatrician, and I think the chance that she came to some kind of incorrect conclusion in, well, certainly, in the cases that are presented in the preventionist and other shows that have given airtime to these quote-unquote, you know, wrongly accused parents, they're not, you know, approaching it in my view in good faith. They aren't presenting information. You know, it's extremely one-sided. And then it's also completely ignoring any access that somebody might have to research a bit.

And, you know, they, like, you know, with the preventionist, I mean, Diane Neary is talking about she's been working on this for whatever, two or three years. And, you know, she wasn't able to, well, she was able to find out what the medical findings were in the child of Amanda, whatever name is. Sarnhawski. For example. Sarnovsky, for example. But rather than looking at that and talking to somebody about, hey, what are these findings indicative of? Could this have been some kind of an accident where this young infant fell out of a bassinet in some way? They could easily have found that the extent of the injuries and that child was far beyond what made any sense with. the history. And so, you know, in like cases in the movie and things that I was involved with, there's all kinds of public record that somebody could have looked at that would have made it

clear that, well, this person is saying this, that they were wrongly accused, but there's an awful lot of evidence that that's not the case. But they're instead portrayed in all kinds of reports over now five, six, seven years that, oh, the parents said this and therefore that is the truth, which, you know, is ridiculous. People don't come into emergency rooms and say, oh, I kind of lost it and threw my kid on the floor. They tell other stories. And, you know, a child abuse pediatrician, for example, in that scenario is left to look at what are the injuries that the child had. And what kind of forces and scenarios and things would typically cause this severity of injury? And is there any way that what's being presented makes any kind of

sense in a scientific medical physics kind of a sense? And they don't even, I mean, I understand Diane Neary's not scientist. She's a creative writing PhD. So maybe that's what our problem is. But to not even try to delve into the science further over multiple years. And she's talking about all of her staff that, you know, spend all kinds of time research. Well, what were they researching? I don't know. Yeah. I mean, your guess is as good as mine. And I, you know, I want to talk a little bit in more detail about the Amanda Sarnovsky case and kind of what are some of the details that were left out. But I think before that, to your point. And, you know, Like, nothing against creative writing majors.

I also am a creative, was a creative writing major. One can learn to be a journal. No offense. Intent. No offense. Yeah, I know. But, you know, like, you have to bring, as a person who is a novelist, who also now is working on this show, I bring a different skill set to both of those things, you know.

In one, you have to fact check for the other one. You just get to make stuff up. So, anyway, I was struck after listening to these three episodes by what Neri came up with. after spending two years with the resources of the New York Times on this story. And it really feels pretty surface to me. Like, do you see anything in this reporting that points to Dr. Jensen being especially overzealous or, you know, or really just doing anything that, you know, there are, and again, I think the lack of curiosity here is pretty stunning because there are protocols for evaluating abusive head trauma and evaluating

Munchausen by proxy. And like, these are, these are things that there is, you know, there are consensus documents on. And like, it's not, it's not a mystery, right? It's like not, there's a way that child abuse pediatricians do their jobs. And I struggle from listening to this to identify, you know, if you sort of screen out the noise of the lawsuit and the Pinsley report, which in my opinion should be screened out, right? Because they're not actually indicative of any wrongdoing of Dr. Jensen. You really have to dig a little deeper than that, not just present them. But if you screen out that noise, there isn't anything that they pointed to in this reporting that I heard that spoke to how differently Dr. Jensen does her job.

Did you hear anything in this recording that spoke about? No, because they don't really talk. It's not like they said, oh, she came in and she didn't talk to any of the doctors at the hospital. And she didn't look at any of the child's medical history. And she didn't look at any of the lab tests or any of the x-rays or any of the cat scans or any of the follow-up information or any risk factors for the family or all the other things that child abuse pediatricians look at. She didn't try to think through whether there was a possibly accidental or alternative explanation besides child abuse. She just jumped to this conclusion. They have no evidence that they're presenting that that was the problem.

The problem they're saying is that once she identifies child abuse, she's overzealous about trying to keep the children safe. well frankly i've been accused of the same thing by some of these same people i don't apologize for being fairly zealous in trying to protect children who i think are in serious danger so if that's some kind of a you know uh active malpractice on my part or some kind of evidence of my medical negligence or something like that i'm not back in a way just because you know somebody is trying to intimidate me or other child abuse pediatricians to say that you might think there was something wrong here, but the mom says that there wasn't. And so you didn't do your job right or you're acting outside of the typical realm and

parameters of a child abuse pediatrician. It's ridiculous. I know Dr. Jensen. I know she approached complex cases in the same manner that I did and, you know, was well-versed in specifics of radiology results associated with certain types of child abuse and patterns of inappropriate medical care associated with Munchausen syndrome bi proxy cases. I never experienced any kind of interaction with her or any kind of. any kind of, I mean, we did a lot of peer review, quality improvement kind of reviewing of other

teams around the state. I was on that. I was on that review team for years. Nobody ever said, hey, Dr. Jensen rashly diagnosed his child abuse with no evidence. That's just not the situation here. Just because, you know, some comptroller in Pennsylvania or some, you know, mom who had multiple prior reports to or investigations by DCF, you know, said something different doesn't mean that Dr. Jensen didn't do her job appropriately. I want to kind of zero in and some of this is going to take, you know, a bit more digging on this whole situation, which we are going to do a full season on, but I wanted to have some responsive reporting as this is coming out into the world. You know, on like, how should we sort of, what is the proper way to look at a child abuse pediatrician's work? Because it is different than other doctors, right? Well, it's not really, though, Andrea. I mean, child abuse pediatricians take a history, do a physical exam, assess all of the ancillary data, and put all that together, consider a differential diagnosis in your brain, and then come up with a diagnosis and recommendations for a plan.

That's exactly the same thing that doctors do in every scenario. So it's not really different. We have a different specialty than cardiology, sure, but we don't do anything different, really. Yeah, but you have a scarier name. So that's an important piece. No, that's a really good point, Sally. Reproductive care is so important. And did you know that one in four people who can get pregnant will have an abortion?

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Ideally, what should happen is the same thing that happens when another doctor is accused of not doing their job properly or, you know, causing some problem or being a bad endocrinologist or something is that, you know, it may be presented to a board of professional regulation or court or whatever the case may be. And then there are medical witnesses that come and delineate why this doctor's conduct or conclusions or whatever was unacceptable or incompetent or negligent or whatever the allegation is. And then, you know, somebody looks at all these pieces of evidence and makes a decision about whether there's any validity to the accusation. But a lot of times in these cases, they're saying, oh, well, there should be a second opinion

if there's a mandatory second opinion if there is a high profile case or something. Well, interestingly enough, most of the cases that have been reported on regarding my evaluation of kids in Florida were reviewed, had a second opinion by the statewide medical director for the state of Florida, because that's how that system is set up. and they concurred with my diagnosis in all of those cases that were reviewed. And actually, interestingly enough, Sally, that was the case in a case that we are going to talk about in the upcoming season, but that also made it into Diane Neary's original article about you, which was the Viviana Graham case.

That was also, I believe, I remember you telling me that abuse was confirmed by the statewide medical director in that case as well. Exactly. And in Maya Kowalski's case, that was reviewed by, my report was reviewed by, and actually the whole pile of records was sent to the statewide medical director because it was fairly controversial even at the time that the case was going on. So the idea that a parent or an alleged perpetrator should be the one who picks the doctor to decide if a child abuse pediatrician did their job correctly is ludicrous. you know, you don't get a pediatric cardiologist to evaluate whether an adult orthopedic surgeon did their job properly. And so what you have to have is a child abuse pediatrician. We're board certified. We're experts in this area. And especially if cereal and the New York Times and New York

magazine or whatever are saying, oh, no, no, no, no, we're not trying to put out all kinds of negative information about child abuse pediatricians. Oh, no, no, they're doing their job and it's great and, you know, somebody has to do that and, oh, what a noble profession and everything. It's just these specific doctors over here. So if that's the case, then those specific doctors over here can be reviewed by other child abuse pediatricians. And if the other child abuse pediatricians says, oh, the evidence was all there. Yeah, I would have to say I agree. Then that needs to be the end of the case. Not that the parent gets to go out and hire some, you know, person that is going to say the opposite. I mean, you know, that's a whole, that's a whole cottage industry,

which people may not recognize, right? Oh, yeah. Like, you know, you've got Dr. Richard Bowles, who is always saying, you know, is diagnosing mitochondrial disease. You've sort of got this, like, list of doctors, and I'm going to get into that in the next season that, like, this is a list that gets shared amongst parents, right? Like, there are this sort of list of people who make very good money testifying in court. Dr. Eli Newberger was one, got paid over $100,000 to do a deposition, the deposition you mentioned in the Kowalski case. You know, this is no, this is no small cottage industry of like you can find a doctor

to disagree with any decision. Right. And like the Kowalski case, I mean, it was presented. to the jury as if Dr. Hannah and Dr. Kirkpatrick were on a par with all kinds of other pain management and CRPS doctors and things like that. Well, what about the guy from Stanford who said, you know, what in the world were they doing? And, you know, this was dangerous and no, I wouldn't have given this amount of ketamine to anybody, let alone a 10-year-old child. So, you know, that guy comes up and says those things and then they still portray that oh this was very reasonable

and there was no reason to be concerned about or safety or you know things like that it's disingenuous at best yeah and i think there really is like a lot of mental gymnastics that go into making these cases look like something that they're not and that i think in terms of journalistic integrity is really my big beef with it right because this has real consequences, and journalistic ethics matter for a reason. Many of the cases in the preventionist aren't examined in any detail, and it's not clear what records families provided to the serial team. They declined to answer that question when I reached out to them for comment.

But the third episode follows the journey of a mother named Amanda Sernovsky, who was charged with abusing her seven-week-old baby and ended up pleading no contest to reckless endangerment of a person. Amanda claims the injuries were accidental. Here is her version of events as recounted on her lawyer's podcast, Lee Galli at Law. It was December 14th, approximately 5.30 in the morning. When I woke up to a thud on my floor, I woke up and I seen my seven-week-old on the floor and my two-year-old in his bassinet.

His onesie was zipped down, diaper was off. I looked at my two-year-old and I asked her what happened and what did she do. I immediately called my sister. She didn't answer. I called the kid's father. He did not answer. I called their doctors, obviously. I mean, it was a weekend.

And once the recording came on saying if it was an emergency to call 911 and that's what I did. Amanda tells Diane Neary this same version of events in the preventionist. And it's an unusual story. So I wanted to get Sally's take. I wanted to sort of start with this piece about, you know, it's a seven-week-old baby at the time. And she says, and apparently she's told, she told some conflicting versions of this to the paramedics and then later at the hospital, which is obviously, they kind of left that out, didn't they? They did. That was in the news reports, but that that was left out. And I guess leaving, you know, some recognition that this is a stressful situation and et cetera. But I mean, certainly like telling a different story over time is

certainly like a red flag. And I just wanted to start with this story. Because as I often find when I hear some of these narratives. I have really little kids. I have a seven-year-old and a three-and-a-half-year-old. This time of my life is not remote for me. Yes. I can't quite, and I really am trying. I'm really genuinely trying.

I can't quite wrap my head around. I'm not saying it's impossible. I would love to see a scene reenactment. Let's just say that. Which is something that the police do. We don't know sort of the outcome of that. Well, they do sometimes. They don't, like, I have yet to see law enforcement set up where the two-year-old's there.

For example, like this story. And, you know, I don't know. She's talking about the two-year-old, like, they can talk and things. So fine. Here, come out of your bedroom, do whatever you did. and climb in the bassinet, let's see you do it. Because I think that's fairly far-fetched, especially with the rest of the story.

Maybe if the bassinet is like right up against a couch and the two-year-old climbs up there and, you know, bassonets are not the most stable structure. So, you know, a big kid like that, that's why you can't put a six or eight or ten-month-old in a bassinet because if they move in the wrong way, the thing's going to flip over. So a two-year-old is way bigger than a six-month-old.

So how the heck did that two-year-old get up in there? Presumably there's no noise. She hears the thud is the thing that finally wakes her up. And then she supposedly, you know, awakens to this scene. Well, to me it doesn't make any sense. And then she throws in that the baby's onesie was undone and the diaper was off. So this is all going on while she's still sleeping. or something? I mean, I just, I find it interesting that the people who are sort of her champions

present this as like, oh, this is the story. Doesn't that seem plausible? And to me, sorry, it doesn't seem plausible? Yeah. And, you know, like, I think the point about the bassinet possibly being close to the couch is, I'm just thinking of like when my babies were really little and I did have them in bassinet so that they can sort of sleep right by me and you can, you know. And like also usually notably, bassonets have high sides so that the baby can't roll out. So then you would also have to have, you know, because they didn't, she didn't say the bassinet was tipped over. Right. She said that the baby was on the floor and the two-year-old was in the bassinet. So right. Then we got the scenario, what, the two-year-old chucked the baby out? I mean, tossed it out. I mean, yeah. Again,

and didn't hear anything happening until all of a sudden the baby's on the floor. As you can probably hear, I'm kind of twisting my brain into a pretzel trying to give this story a fair shake. I'm also trying not to see this admittedly bizarre story through the lens of what else I know about Amanda, because this wasn't the first one of Amanda's children to end up in the hospital with a suspicious injury. According to Serial, Amanda left the father of her first child after he was indicated for abusive head trauma of their one-month-old baby. And then there was an incident with a father of her other four children.

Yanni Castillo pled no contest to aggravated assault of a child in 2019, after a police investigation determined that his then two-month-old daughter's broken arm was a result of abuse. According to court records, Castillo told doctors and investigators of shifting story about how his daughter's arm broke. Initially, he said he woke up and heard the child screaming and found her with her arm dangling behind her. her back. His subsequent actions were also highly concerning. When asked why he drove his daughter to the

hospital rather than calling an ambulance, he told them that he thought it would be quicker. However, records from the investigation show that Castillo sent a text message about the child's injury at 1.20 p.m. on December 5, 2017, but didn't arrive at the hospital until 5.30 p.m. more than four hours later. Records say Castillo took a polygraph test and admitted he was responsible for breaking the baby's arm. He eventually dropped the story that he simply found his daughter with her arm dangling and told the police he was changing the baby's diaper when he, quote, turned her the wrong way and heard a, quote, pop and snap sound. Serial presents this highly suspicious series of events like this. Quote, Yanni lied at first, but finally admitted that he'd been changing the baby's diaper

when her arm got caught behind her as he rolled her from one side to the other. An x-ray showed a fracture, which can happen like that by accident. But a child abuse pediatrician believed the injury was indicative of abuse. Yanni denied he'd hurt her on purpose, but eventually pled no contest to aggravated assault. End quote. So, can such an injury happen, quote, like that by accident? Not really, no. As news reports recount, Dr. Jensen explained to investigators that baby's bones are extremely flexible,

and it's harder, not easier, for their bones. to break than it is for older children or adults. With the caveat that I don't have the medical records in this case, there's peer-reviewed literature on the biomechanical implausibility of a baby's arm breaking from rolling or a diaper change. The elements of the shifting story and the delay in seeking care are also called out in the literature as being significant predictors of abusive injuries.

And then there's just common sense. Baby's bones don't just snap while you're changing their diapers. And this seems like something you'd know if you'd encountered a human baby. And there was an entire police investigation and a criminal conviction, not just one doctor diagnosing abuse. And it all just begs the question of why Neri and Serial are bending over backwards to diminish this incident. We then get to the third child from this family to be hospitalized with injuries diagnosed

as abusive, Amanda's youngest son. According to news reports, Sarnovsky also changed her story about how this particular injury happened, telling the responding paramedics that she was out of the room when the incident happened, heard fussing and crying, and returned to find the baby on the floor. She later shifted her story to the one she told investigators and then Serial that she'd been asleep when it happened and was awakened by a thud finding the baby on the floor. Serial doesn't include this detail about Amanda's shifting story, and they also leave out that according to a doctor who interviewed her other children, they allegedly made statements such

as mommy is very bad and mommy spanks me on my butt. One child reported being afraid of Sernovsky. So you may be wondering, how does Diane Neri turn this series of events into a story about a mistaken diagnosis by Dr. Jensen? According to Neri and according to her producer, you know, she sent these, and I think what she sort of presents as a smoking gun with this case, right, is that she presented anonymized medical records to other child abuse pediatricians and they said, well, how about who? Who was that? Especially if you're going to use that as the evidence that Dr. Jensen isn't doing her

job properly. I mean, you can't just throw out this anonymous kind of thing with that sort of consequence. I mean, she talked to Dr. Alexander. Did she send it all to him to take a look at it and see what he thought? I mean, and I think a lot of... Yeah, like, you have an extremely experienced child abuse pediatrician willing to go on the record with you. And she appears to have not, or not that aired anyway, asked him a single question about, like, Munchausen by proxy abuse, which they, you know, despite their predestations spent a third of the show talking about. It seems maybe like there would be a good question in there. And yeah, I mean, I don't believe that they mentioned having asked him specifically about this case,

which feels like a missed opportunity. Right. And, you know, I think one of the things that I found in some of the media reports about me was that they did actually quote child abuse pediatrician or two in some of the articles. But I would really challenge, like, what question exactly did you ask? You know, there was one thing where, you know, there was this accusation that I always came barging in and never introduced myself and was like basically rude to people all the time and things like that.

And they said, they asked a child abuse pediatrician, well, should you introduce yourself? Oh, yes, I always do that. And then they switch it around as it. Yeah, that's a really good. I actually remember the exact quote you're talking about. So this was in Daphne Chen's USA Today piece called Bad Medicine. And she asked Dr. Jill Glick from Chicago, who we have also had on the show. She posed a question to her that was something along the lines of,

what would you think if, you know, a doctor barged in and didn't introduce themselves and Bob and she said, well, that would be bad. I mean, I wouldn't support that. That would be bad medicine. Right. And yet there's no evidence that you did those things. and they nonetheless used bad medicine as the plural quote for the whole thing. So I do think that that's like we sort of know and that was one of my questions was,

well, what did you ask them? And I was really surprised, like having talked to a number of child abuse pediatricians and many doctors for this show, you know, the quotes that sort of like are not direct quotes, but the answers that Neri is referring to, you know, where she said, well, the child abuse, the other child abuse pediatricians didn't, you know, think this was abuse. they said they, oh, would have qualified, you know, said this was an accident. And I was like, that to me seemed really surprising because I can't imagine a child abuse pediatrician saying something like that based on only anonymized medical records because

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That's one month free when you sign up at Acorns. Early.com backslash nobody. Acorns Early card is issued by Community Federal Savings Bank, member FDIC, pursuant to licensed by MasterCard International. Free trial for new subscribers only. Subscription fees starting from $5 per month unless canceled. Terms apply at acorns.com backslash early terms. The chief piece of evidence Neri presents to cast doubt on Dr. Jensen and Dr. Doshi's abuse diagnosis is that several other doctors, whom Neri presented with anonymized medical records disagreed with it. However, these doctors are unnamed, and that's important because

if you have the time and resources, you can find a doctor to say any case is not abuse. There's an entire cottage industry devoted to this. It's a well-known issue in the field, and we have a lot of reporting coming up on this in our upcoming season. I shared the near-fatality report matching this case, which gave an overview of the baby's injuries, with Sally and asked for her interpretation. Well, the child had skull fractures on both sides of the head. When you land on the head, you can get a skull fracture, but it's not on the other side of the head. It's on the side that you land on. Had subgalial hemorrhage, so hemorrhage under the scalp, that's a hard enough impact to the head

that you have a lump of blood over the fractures and a layer of blood all over the brain. I think subarachnoid hemorrhage as well. Anyway, there's all these things. Well, we know one of the things that is very important, an important lesson that we learn in child abuse pediatrics is you have to be able to figure out what things are reasonably explained by the accidental history that's presented and what things are not. So if this baby had come to the hospital and there was a linear fracture on one side of the head with a bump over it and a little blood under it, given the scenario, I would say not only would Dr. Jensen have not concluded that it was child abuse, but the hospital wouldn't have called it in the first place. But the medical findings, all the science of it does not make any sense for that explanation. It's much too extensive of injuries for, you know, okay, fine.

You don't want your two-year-old to chuck your seven-week-old out of the bassinet. But kids don't die from that. Kids don't get hemorrhage all over their brain. They don't get, like, numerous skull fractures from that kind of an accidental scenario. Things like that happen, but they don't cause the medical findings that were there. So either they didn't send all of the medical findings to the child abuse pediatrician, whoever it was. And so they didn't have the full context to make. any kind of statement about whether Dr. Jensen made a correct decision or not in diagnosing

child abuse. They also, I mean, I don't, I guess you're back to what question did you ask? Because, I mean, it just doesn't really make any sense that a child abuse pediatrician who really had the facts would say anything other than, well, that looks pretty straightforward to me. Yeah. And, you know, they were similarly asking these caps. apparently, I mean, from, you know, context clues, if they would have recommended, if they would have recommended separating the children. And that's just, I mean, number one, like, that's not the specific job of caps. And, you know, you do, there, I think there are, like, mileage may vary

in how reports are written. You were talking about sort of, you know, if you have a finding of abuse that you're not afraid to advocate for those children to be in a safe home, but you're not, you know, you're not the entity that makes custody decision. and, you know, I, there was a history of abuse with this family. And so if they were being presented anonymized medical, right, anonymized medical records, presumably they are not telling the caps that they're asking about that history of abuse or the issues with the story. Left out anything about the risk factors.

I just, I mean, I guess it's possible that a young child abuse pediatrician who had very limited exposure to, serious cases like bad head injuries might not have the experience and to a certain extent the expertise to, you know, look at full information and come to the right conclusion. But I think that's highly unlikely that that was the problem just because, I mean, I feel like it, the only thing that makes any sense to me is the person did not have the information that they needed to answer the question. Or they might have said that about some completely different scenario. Amanda tells Neri a really heart-wrenching story about her years of trying to get custody of her son back, a battle which at the end of the series appears to be

ongoing. And it is a heart-wrenching story. News reports about Amanda's arrest show a mom who is really struggling at the time for her baby's removal. According to local news coverage, Amanda reported struggling with PTSD and postpartum depression. The article describes how police uncovered phone records about Amanda struggling to feed her children, especially with a partner in prison, and allude to possible issues with substance abuse. It's clear that Amanda needed some help, and our current system often isn't great at providing that help. The story is tragic. I just don't believe that the tragedy is a false allegation of abuse. And no matter what you think happened here, absolutely none of this will be helped by giving Amanda a platform to share

her extremely dubious story that actually the injuries her baby sustained were her daughter's fault. This situation with Amanda and her children, that really, I found very unnerving specifically because, you know, in this third episode when they're talking to Amanda, Amanda repeatedly reinforces the story that her two-year-old child, who's now six or seven, did this. And that's clearly a story that that child has been told. And she says that the child is suffering because of it. She says that she's having these behavioral issues. And she says that, you know, the child feels like it was her fault that their baby brother got taken away.

And that's- Because Amanda has told her that 25 times. times. Right. Because a two-year-old is not going, let's say for the sake of argument that this story is completely true and that that child when she was two did toss the baby out of the bassinet somehow. Nonetheless, that's not something that they would remember contextually on their own. And so I really like, that really sat wrong with me that the podcast is reinforcing that idea, which is clearly harmful to the child. I have a lot of questions about Amanda's motives for doing this, but also just I think the journalist, you know, the journalists who are working on this,

like, did you not think that, and I think they could have told this story. Again, this is an editorial choice. They could have told this story in such a way that it did not so directly place blame on a six-year-old child. They certainly could have left out Amanda's several statements, I believe, that it was her two-year-old daughter's fault and she was suffering because of that. Because, you know, the interesting thing is, so this two-year-old, she's got some behavior problems. I mean, you know, obviously I'm somewhat speculating, but children who are in scenarios where they suffer adverse childhood experiences, so violence in the home, a lot of other things, but particularly violence in the home, are at high risk for mental health.

health problems. And, you know, a two-year-old in that in that whole scenario, especially who is being told that this, oh, it's not your fault, but it was your fault. You know, that, that is really irresponsible. And in my view, you know, somewhat emotionally abusive on the part of her mother. And then for multiple journalists and their editors and some supervisory people to all fail to consider, yeah, the adverse effect on that little child and other similar little children who get thrown under the bus by somebody. I mean, I was kind of stunned that I was hearing that and trying to act like, I mean, I think the child's been back with the mom for over a year now or something and, hey, take her to the counselor. If you're that concerned about, you know, what's

happening. I can't imagine some therapist that told the mom, hey, keep talking to her about it was her fault that her brother got hurt. And don't worry, mommy's trying to fight this in the media or in court or whatever. I mean, that's not a thing. So. No. I mean, no. You know, and again, like, I think I just have such a, you know, my daughter is, is that age. And I, I can't imagine, like, I can't imagine not trying to protect her from in that situation, even if it did happen, right? Like, even if that was the truth, like, I just wouldn't throw my kid under the bus like that. I want to dig into the near fatality report that serial mentions in this case. Neri frames this as a puzzling overreaction by Doshi and Jensen, saying that when she showed the anonymized medical records to a series of unnamed doctors,

Quote, all three doctors independently puzzled over the fact that Dr. Doshi and Dr. Jensen had certified the case as a quote near fatality, meaning the baby was in serious or critical condition, end quote. That's the important thing. Is that language is something under Pennsylvania law that requires one of these multidisciplinary meetings? We have that in Florida as well where the legislature actually passed. you know, specific diagnoses even, but also, you know, seriousness of injury and things like that, where a child protective investigator can't complete their case without presenting it to experts such as would be at a child protection team. And, you know, so there's some equivalent process with Pennsylvania where if you have a child that's hospitalized, I mean, in Florida, that's one of the

criteria that requires a referral to the child protection team for a medical director or one of their colleagues to evaluate the case and assess because there's, you know, complicated medical information that somebody with a social work degree may not appreciate the nuances of. you need someone who is expert to make sure that that is appropriately assessed and then either that abuses ruled out or that it is understood that this is a scenario where the child's safety is significantly at risk and this was a fairly serious injury that must just be the language in the statute in Pennsylvania that talks about that near fatality. Right, but this isn't like, this isn't just, again, like an independent sort of doctor puts it

in the system that way. It sounds like there is some process to this, which we can, we can definitely kind of look into. Right. I mean, it looked like from some of the documents that as additional severity of brain injury were identified, that the case fell into, a near fatality criteria and they then, you know, followed their path to review the case and that kind of thing. Under Pennsylvania law, a near fatality is not something a child abuse pediatrician personally just declares. It's a statutory classification that's triggered when a physician certifies that a child is in serious or critical condition as a result of abuse. And the brain injuries documented in this case, bilateral skull fractures, multiple intracranial hemorrhages,

shearing and bridging vein injuries, and findings consistent with violent rotational acceleration deceleration forces, qualify it. Once those injuries were identified, the county was legally required to classify the case as a near-fatality and convene a state-mandated Act 33 review. So this is a mandated legal process, not evidence of a crusading child abuse pediatrician. I also found it interesting that the near-fatality report cites the strength of the hospital's coordination with the agency, writing, of particular note in this case, was the provision of images from the child's scans and clear explanations of them. It also notes that, quote, the family was receiving in-home services when this incident occurred. There was a lack of follow-through with the family for ongoing face-to-face contacts and verification of compliance with treatment providers, end quote. As seems to always be the case in these media stories, the more information you learn about a case like Amanda Surinofsky's, the less it seems to fit with Neri's description of it.

As an example of, quote, the cases where doctors and caseworkers are making judgment calls about events obscured by a giant question mark because the only witness is a small child. And for Sally, this just feels like deja vu. It felt familiar, let's say that, in terms of just what was presented. and sort of with great umbrage of look at what is happening to children and their families and things. And like no actual objective information presented that would provide evidence that you're saying something valid. I mean, it's just I I've actually tried to. pursue like some defamation liability, you know, assistance in my own case. And it's disturbing to me that the laws in terms of defamation and liable remain fairly limited. And I think go back

to decades ago when there was limited media available newspapers, magazines, you know, network news, like that. And there's sort of this idea that there was some integrity of the system where they're not going to present information to the public that, you know, doesn't have any evidence to support it. And now, you know, with all the different ways that things get put out into the public now, I mean, still the New York Times, New York Magazine, they have a responsibility here, But they don't appear to have much liability for just letting this stuff get thrown out there. And I mean, it's really unfortunate. And child abuse pediatricians are among, I mean, I'm not saying doctors aren't well paid or anything like that.

But child abuse pediatricians are kind of in the bottom rungs of physician income. And, I mean, personally, I certainly couldn't afford to pay millions of dollars. to some attorney to try to get some, you know, vindication or justice or something about this. And the idea that people in the media and attorneys, for that matter, Greg Anderson, the one that, um, alley law, whatever that. I mean, these people can apparently just say anything they want with no evidence to back it up. And there's nothing you can do about it. And this brings me back to my original question for Serial. What exactly is the point of all this?

There are changes we could make that are well-studied and supported that would greatly impact families like Amanda's for the better. No mom should be struggling on her own with five kids the way Amanda was. I'm not absolving her of responsibility for what she may have done to her child, but I am saying that it's very possible this whole thing was avoidable. We know this from prevention research, but child abuse pediatricians step in when it's already too late to prevent the harm. It is, unfortunately, a necessary role. And what's not going to help any families at all is driving child abuse pediatricians out of their jobs. It will only

mean that these decisions will be made by less qualified people, meaning more errors on both ends, more children being harmed, and more children being removed unnecessarily. It also, leaves more room for grifters, anti-vaxxers, child abuse deniers, and people who, quote, do their own research to be taken more seriously than experts working from robust science. I wonder if there's you sort of connect some dots for us that I've really been acutely aware of in, it's really interesting to see sort of this story, how it was being told in 2023 versus now. in the year of our RFK Jr., 2025, you know, as you were saying, like, child abuse pediatricians are doctors and they follow science and they have standards of care and all these things, right?

Even if they're treated like these sort of boogie men, well, really boogie women, because it really is a lot focused on women. Yeah, which like we could dig into the misogyny of that another time. But, you know, even though they're presented as boogie women who are. you know, just so overzealous in their jobs and so, so overly sure of themselves and so arrogant that they're snatching up babies. You know, that's just not really connected to reality. And I mean, you sort of touched on it previously in terms of the child abuse pediatrician is in somewhat of a different role as far as, you know, it's not a, it's not a thing typically for doctors when you make the correct diagnosis that, um,

family members, you know, attack and hate you. You know, I think, you know, so that's a little different, but I think that there is a problem in the country where, you know, not believing doctors, not believing science, not looking objectively at history and history of illnesses and all kinds of other medical components is really problematic for both adults and children. And, you know, I think that on the one hand, I don't necessarily have a problem with scrutiny of the medical profession and actual identification of scenarios in which somebody is not practicing good medicine or is putting people in danger or, you know, things like that.

I mean, I think there's a pretty robust system for how you deal with that in the medical profession. And to sort of portray that academies of pediatrics, for example, or internal medicine, guidelines that they develop, criteria that they develop, consensus opinions that are put out, recommendations about vaccines or medications or management of blood pressure or management of pregnancy or all different kinds of medical issues that, you know, there certainly needs to be integrity in that scenario, but it's not good for anybody if it's presented as if 98% of internal medicine physicians and their governing bodies, academies, et cetera, making a certain

recommendation for something, portraying that it's reasonable that there are a bunch of quacks. It just, you know, it just doesn't, it doesn't really pass muster to me. You know, it's one thing, I mean, honestly, Dr. Kirkpatrick, Dr. Hannah, those are the people that somebody should be talking about, that they are far outside of, you know, what's considered reasonable practice of medicine and have been far outside for years and apparently are still at it. You know, the idea that those doctors are not criticized in any way, but people who are following guidelines and protocols and, you know, doing thorough, um, objective work and having data behind opinions that they present and things like that. I mean, they're not apples to

apples. I mean, you know, we, we don't want to have a scenario where the media gets people thinking that most doctors are whatever, you know, some long list of bad things. And so we shouldn't trust them and you know with any kind of medical recommendations or or diagnoses or things like that i mean that's that's that sends this society into a fairly dark place what would you like to say to journalists that are possibly embarking on reporting on some of these stories and also people who are absorbing that journalist that journalism who may not have had those experiences in their life where they realize sort of what the stakes are. Well, in one county in Florida, we provided 1,200 medical evaluations a year for children

where there were allegations of abuse and neglect. And that was about 10% of the reports of the hotline that came for Pinellas County, just our county. So, I've seen this in criminal trials, jury scenarios, attorneys, for that matter, I think, judges. I think across the board in this country, people, I think, like to think that child abuse is not common. And very sadly for the thousands and thousands and thousands and thousands of children every year who end up in the hospital from physical abuse or who have very serious psychological problems and even medical problems as a result of experiencing munchausen syndrome by proxy, children who are constantly exposed to violence in their in their household and adverse experiences and things and there's putting your head in the sand and pretending that that's not a thing i mean i get it you know maybe in your child's third grade class nobody got reported to the hotline this year but that doesn't mean

that it's not a serious problem all over the country that goes on and on and on multigenerational abuse that has been happening for decades and serious injuries to children in both, you know, physical and mental capacities. People who are writing these kinds of articles, especially that don't seem to approach it with any real integrity or sense of fairness or balance or anything, you're not hurting me. I mean, you know, it's inconvenient to have people blowing up my cell phone, but you're not hurting me. You're hurting little children because you're portraying to the public that there's witch hounds going on all over the place and parents don't abuse their children. Well, that's not the case. And somebody needs to stand up for these children. And

I don't apologize for choosing to do that. Dr. Sally Smith is a tough lady, and she's kind of understating what she's been through here. I got a little taste of it when she was on my show the first time. This was a series that brought out some of the most vitriolic comments I've ever received, as well as my very first death threats. And while these things are unpleasant, she's right. The people waging this war on caps may be hurting the doctors they're attacking as well,

but vulnerable, voiceless children will pay the real price. But the voices of victims and abuse survivors weren't the only things left out of serial's coverage. If I thought Jensman's wrong, I would have told her in a flash. I had no problem with that. And she would have had no problem in receiving that information. She might, you know, want to argue or discuss the case. So that'd be fine.

That's what you do as medical professionals. But it never happened. That's next time on Nobody Should Believe Me. Nobody Should Believe Meek is produced and hosted by me, Andrea Dunlop. Our editor is Greta Stromquist, and our senior producer is Mariah Gossett. Research and fact-checking by Aaron Ajay, administrative support from Nola Karmouche.