Expert Witness

I had the questionable privlege of being an expert witness in court this week. One of my patients wanted me to testify for her in court despite the fact that my testimony would be highly unlikely to improve her chances of winning her case, and would probably harm it. I tried to get out of it. My boss advised me to ingore the first subpoena, which I did. The lawyer threatened to get a bench warrent. I sent him a written statement of what I would say. He tried to talk her out of it. She insisted. He was representing her pro bono as a court appointed attorney. I have to give him credit, he really tried to listen to her wishes, despite her inability to really understand what the consequences of her decision would be. Finally, I still had to go to court.

Although I don't want to divulge much of the details of the case, my testimony, as I expected, was fairly damning to my patient. No, she was not thinking clearly at all when I first saw her. Yes, I prescribed medicine, yes she was much better when she came back a month later. No she never followed up with me afte that, no she would not have enough medicine to last until now, no I don't believe she would have a normal mental state off the medicine, no I don't think she was highly motivated to work hard in therapy, take responsibility for her behavior, or make the kind of changes in her life she would need to in order to win her case in family court.

It was awful to have to look at this patient while saying things that condemned her case to failure. But what bothered me the most was that this woman, who'd had a terrible childhood, and who had a terrible life, who had little education and very few life skills, had actually formed something of a connection with me. She had at least trusted me enough to tell me her story and to ask me to testify for her in court. She had thought of me as a friend of sorts. I suspected she had been manipulating me to get what she wanted, but I'm not sure she realized that's what she was doing, or even that it was wrong. What bothered me was that I was letting her down, I, who she had trusted enough to talk with, to tell secrets to, was hurting her in public, in court.

I left the court room as soon as I was released; I didn't want to witness her anger, see her lash out at me. Her anger alone would spoil her case with the judge, and she certainly had anger seething in there. But I worry that she will have an even harder time ever trusting an authority figure again. A colleague suggested that a good sign of her poor judgment was her wanted me to testify. I wish there was some kind of system, support, something, that this woman could be plugged in to to teach her what she needs to know to survive and thrive in the world. As it is she is lost in the cracks, no stable place to live, using drugs and alcohol, unemployed, uneducated, and far too proud to directly ask for help. And now I fear that even if help is offered (or court ordered, as her appointments with me had been), she will be too suspicious, too afraid of being hurt, to trust it. She needs a mother, has needed one her whole life. Perhaps for half a minute I had been a very pale version of that mother for her.

She expected me to rescue her, to bail her out, to even lie to get her what she wanted. It's probably the fantasy of what a mother should be to her. Perhaps she set me up to fail her, just as her own mother had failed her in the past. And when I did fail her, it reinforced her identity as a survivor who doesn't need anyone, and can't trust anyone anyway.

I know that as adults we are responsible for our own bad decisions. When I look at this patient, though, I see that angry, helpless, and lost child inside. She makes the decisions she needs to survive. The concepts of consequences, of future, of responsibility toward others, mean nothing to her. She figures out where she will sleep tonight, where she will get food, what drug might quiet the voices in her head. And that is enough for a child to accomplish in a day. And is too much for any child to have to do alone.