39
I was already seated at the plaintiff’s table when the Coopers walked in the next morning. Compared to how she had left yesterday afternoon—visibly suffering a wide range of emotions—today, Madeleine had her chin raised high and she carried herself like a queen. She wore an expensively tailored dark suit and had a pink scarf artfully tied around her neck, expertly accessorizing it. However, a couple of accessories she’d sported the day before were now conspicuously absent: her children.
I glanced at Declan, who was deep in dialogue with Patrick Nevin. Rosie’s pediatrician, Dr. Ryan, was scheduled to go on the stand first thing this morning and I knew that Declan wanted to make sure Nevin was adequately prepared to guide her.
He had confessed to me previously that while she was an obviously talented physician, she had not presented well in her preparation for trial. Declan was intent on making sure she came across comfortable and secure in the witness stand—he didn’t want any medical doubt to be introduced this time around.
“Looks like Jake and Clara stayed at home today. I’m betting that isn’t a coincidence,” Alison whispered. “I wonder if it was Madeleine who put her foot down. There is no way any mother would like having her kids listen to this stuff,” she muttered, turning back to me.
But unwilling to be drawn, I simply raised my eyebrows and sat back in my chair, thinking back on what had gone down in the courtroom yesterday. It hadn’t been pretty. In fact, it had been downright upsetting. Worried about losing out on a holiday...
And, if anything, it had only escalated interest in the trial and added even more fuel to the media fire.
“Dr. Ryan is here,” Alison said, turning back in her seat. “She looks good, Kate. She seems calm.”
Shifting a bit in my own seat so I could look behind me, I waved a small hello to Dr. Ryan at the same moment the bailiff asked that we all rise. The judge was entering, and court was starting.
Patrick Nevin wasted no time calling Dr. Ryan to the stand. I was happy to see that Rosie’s doctor did indeed look poised and confident. The nervousness she had apparently shown in preparation was gone, and the barrister artfully led her through a series of questions about my daughter’s health, what she was facing currently, as well as her ongoing prognosis.
Dr. Ryan outlined in stark detail the very serious side effects of the measles virus Rosie had suffered and how encephalitis was essentially an acute inflammation of her brain directly resulting from the infection.
“The brain becomes inflamed as a result of the body’s attempt to fight the virus. In Rosie’s case this was particularly severe, as her brain suffered repeat convulsions. And when the anticonvulsant drugs we administered did not work, we needed to medically induce a coma so as to essentially give her brain a rest from the seizures. However, throughout the course of those seizures, Rosie suffered hypoxia, a temporary loss of oxygen to her brain,” the doctor continued. “The prognosis for such an occurrence depends on the duration of the episode and, unfortunately in Rosie’s case, the oxygen loss was prolonged. Though, thankfully,” she added, glancing encouragingly toward me, “the resulting damage to the brain was not irreversible. What all this meant for Rosie was that she basically needed to relearn and regain many of her day-to-day physical abilities—such as using her limbs—but retained much of her neurological faculties.
“She continues to receive physical and occupational therapy both at the hospital and at home, and while her prognosis is good from a medical point of view, as you can imagine, her life, and that of her family, has been changed utterly.”
While it was unsettling to hear my Rosie’s medical history and the injuries she’d sustained painted in such blunt and bleak terms, I knew that the judge needed to hear all this from the horse’s mouth. I thought of the innocent little girl who was currently at home under the watchful eye of her nurse and wondered if life would ever be the same again. There was no point in sugarcoating the truth—this was our new reality.
Once Nevin concluded his questioning, he gave up the floor to opposing counsel.
It was their turn to cross-examine Rosie’s doctor. And, as expected, Michael McGuinness did not wait to introduce the doubt re transmission of the virus that Dr. Barrett had hinted upon the day before. He brought it out front and center, and even while I cringed inwardly, I encouraged myself to get used to it.
“Now, Dr. Ryan,” stated McGuinness, “let’s talk about the timeline for when each little girl got sick. Would you agree that Rosie O’Hara might well have been the first to contract the disease, even if we can all agree that it was Clara Cooper who presented first?”
Dr. Ryan paused. She had her game face on. “I cannot comment on Clara Cooper. I’m not her attending physician nor am I familiar with any of her medical records.”
McGuinness raised his hands apologetically. “Of course, I understand. I was simply asking your opinion in that regard, that it’s quite possible Rosie O’Hara could have been the one to contract measles first?”
Nevin jumped to attention. “Objection. Speculation.”
“Sustained,” said the judge automatically.
Shrugging ever so slightly, the defense barrister was quiet for a moment as he looked to rephrase his question.
“Dr. Ryan, in your expert opinion, is it possible in general terms to trace the course of a disease such as measles backward? Possible to trace it back to a ‘patient zero,’ so to speak.”
Shifting in her chair, Dr. Ryan considered the question. Finally, she answered. “I think the question is a bit simplistic. And let me explain why. Yes, at its most basic level, with a disease like measles, it would of course be possible in some instances to trace it back to patient zero. In large-scale epidemics this might be the case. For instance, there was a widespread outbreak in the USA a couple of years back that was said to originate in California. The epidemic spread to almost two hundred cases in eighteen different states. Yet US health officials couldn’t pinpoint the exact origin of the outbreak, even with those large numbers. When the CDC got involved, I believe they were able to match the strain of that virus to one that initially started in the Philippines—it had the same fingerprint, so to speak. However, it was not possible to determine with whom that outbreak started, and a patient zero was never identified.” The doctor paused for a moment and then continued.
“On the flipside of that, there was another situation, also involving the Philippines. A couple of US missionaries had gone there and this was linked to one of the largest measles outbreaks in decades. The disease was localized in Ohio, among the Amish community in which childhood immunization is uncommon. Ultimately, it could be determined that members of the missionary group who had contracted this in the Philippines returned to the US. So investigators could determine exactly who brought the disease back.
“I mention these two cases simply because I want you to understand that the scope of an outbreak matters most in determining its origin. The mere fact that there wasn’t a larger measles outbreak in this area at the time Rosie and Clara contracted the disease makes it nigh on impossible to determine who the primary carrier could be. But Clara had just returned from the US, whereupon a smaller-scale outbreak had occurred, so it is reasonable to suspect, as an unvaccinated child, she picked it up while there.”
The barrister didn’t look at all pleased with this answer, but he pressed on.
“But what if it could be determined?” he asked and I felt myself staring so hard at the back of his head it was as if I wanted to open up his skull and read his thoughts. Was he aware of some other point of origin, other than the Florida one?
Dr. Ryan shrugged. “I can’t see how. This outbreak wasn’t a blip on the HSE’s radar—in fact with only two patients involved, technically it’s not even an outbreak. And it wouldn’t have been at all, save for this court case. This involves two little girls, Clara and Rosie, attending the same school. To my knowledge, no one else at the school or any other person in the area was infected thereafter.”
I was glad that Dr. Ryan was taking Declan’s advice to always use the girls’ names when referring to them together, unlike the defense barrister, who’d so far spoken of them in more formal terms.
McGuinness nodded, as if he was carefully considering this. “Indeed. And, of course, no national health agencies have been deployed in this regard. I agree with you. But surely it’s not too hard to walk backward in the lives of two five-year-old girls?”
Nevin jumped up once again to object, but Dr. Ryan was already answering. “That isn’t a medical question I can answer. I would suggest you refer that to the girls’ parents.”
“Thank you, Dr. Ryan. We truly appreciate your time this morning,” replied McGuinness, who immediately turned on his heel and walked back to where the Coopers sat with their solicitor.
Matt Townsend had a small smirk on his face, and my mind immediately began to race as I wondered what ace card the defendants’ solicitor evidently believed he had up his sleeve.