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Witness for the Prosecution
by Marita Lind, MD, as told to Jerry Carey

Some people get junk mail, I get subpoenas. In a typical month, I get about a dozen faxes or letters inviting me to be a “witness for the prosecution” in court cases involving child abuse and neglect in south Jersey.

Answering subpoenas was not on the list of things I wanted to do in life when I started out my career as a pediatrician. But it became part of my life when, in October of 2001, I joined the staff at the Center for Children’s Support at UMDNJ’s School of Osteopathic Medicine.

Working at the Center can be exhilarating and exhausting. We’re providing absolutely essential services, but our resources are limited and our task is daunting. Statistics show that one in four children in this country will suffer sexual abuse before turning 18 years old. Our Center provides diagnostic services and treatment for children who have suffered sexual abuse, serious physical abuse and neglect in the seven southern New Jersey counties. Most of these children are referred to us by law enforcement or child protective services. Our Center’s pediatricians assess and arrange for the children’s medical needs while our staff of psychologists provide counseling services for the children and their non-offending family members.

Coming to the Center from a private practice was a big shift for me. It meant that I would no longer have the joy of following healthy, happy children from the time they are born until they grow into young adults. Instead, I’ll usually only see the same child once or twice to determine the presence or extent of any injuries the child has suffered. Along with a medical exam, doing what I call “my doctor thing” means talking to the child about why he or she is there and pulling together as good a medical history as possible from the child or the person who brought the child to my office. The problems that bring these kids to my office are very different than most pediatricians see in a general practice. Some kids have experienced things so terrible that when I leave the office it’s hard to let go of what I’ve seen and heard.

A big part of my job is to be a sort of medical detective. It’s a piece of this whole other legal aspect that comes with caring for these children. I spend a lot of time gathering information, writing very detailed reports and trying to pull together medical histories that are as chaotic as these children’s lives have been, and this casts a very real shadow of urgency on my work. I have to judge if a toddler’s burns or broken bones are accidental or inflicted, or if a child’s claims of sexual abuse are justified. The ramifications of my decisions are enormous for that child and the child’s family.

Because of the type of work I do, it’s easy to feel a bit isolated. I learned a long time ago that if I want to have a nice time at a dinner party, I shouldn’t tell people what I do. Aside from the obvious confidentiality issues, my work is unpleasant. You just can’t have a casual conversation about child abuse. I even find it difficult to explain to my two older children. They don’t — can’t — possibly comprehend what my job is about. Ask them and they’ll probably tell you that “Mommy takes care of kids that are hurt and she has to go to court even if she doesn’t want to.”

Do I enjoy going to court? Not even a little bit. I see being in court as an intrusion on what my career is. Let’s face it. Clinical doctors like to see patients. That’s what we do. For a physician, being in court is like being in the operating room without knowing any of the rules. Sometimes I wish that people would just read my reports, do what I recommend and not ask me to come to court to testify. I know that will never happen, though, just as I know how important it is for me to be in court. Every time I testify also reminds me how brave these kids are when they come forward and talk to police officers, lawyers, doctors, judges and juries about what has happened to them.

As an expert witness, I’m in court because I have specific information that can help other people make decisions about what will happen next to a child. It’s my role to educate the jury, to explain what I found while examining a particular child, regardless of who is asking me the questions. Usually, testifying in court isn’t the rapid-fire,dramatic encounter depicted on television shows. It’s a slow, meticulous process and, at least half the time, the person asking me questions will be trying to discredit the reports I’ve written or call into question the judgments I’ve made.

I think I can honestly say that I’ve gotten good at talking about the things people don’t talk about. Helping a jury comprehend the facts sometimes comes down to that. A lot of adults are understandably uncomfortable talking about child abuse. Because they’re uncomfortable, they sometimes minimize what’s happened to the child. This can happen with a lot of people in these kids’ lives — their non-offending parent, their teachers, even the law enforcement officials investigating their case.

I just wrapped up my last stint as an expert witness before taking some time off to welcome my third child to this world. This last case was a little unusual because both the prosecuting and the defense attorneys subpoenaed me to testify. That morning, my obstetrician recommended that I stay at the hospital because it looked like my baby might be planning an early arrival.

“You don’t understand,” I told him. “I have to be in court at one o’clock!”

As a physician who is also an expert witness, I see many children who have spent the first years of their lives stuck in some of our country’s biggest social problems. It casts a very real shadow of urgency on my work. My role is to be an advocate for children, to speak up for them, and to help them get justice.