Psych Nurse Says Lindsay Clancy Was Turned Away From Treatment (Trial Day 11)

“Day 11 of the Lindsay Clancy trial gave us a very disturbing look at the unraveling Lindsay Clancy in the months before the killings. And then we spent most of the day with one of Lindsay’s mental health professionals, nurse Rebecca Gelbota. She is the third of her practitioners, Lindsay’s practitioners, to line up against Lindsay Clancy.

But what she had to say was a very mixed bag that helped the prosecution and also the defense. We’ll talk about how that could be. But the most important witness of the day for the defense was one you would never guess. She was a treating nurse who saw Lindsay one time, and she said almost nothing. And the defense asked essentially no questions at all.

We will talk about why she made such a difference for the defense. Plus, TikTok has entered the courtroom once again. Hi, y’all. I’m lawyer Lee. Thanks for watching coverage of day 11 of the trial of Lindsay Clancy, who is on trial in a Massachusetts courtroom accused of murdering her three young children. We’ll start with that unimportant witness who turned out to be really important for the defense, and not because of anything she said on the stand.

In fact, by the end of the day, you probably would not even remember nurse Paul. Here’s why she was so important. Lindsay’s psychiatrist and mental health professionals are all showing up to testify against her. That’s not entirely surprising. She blames them for failing to treat her and for over-medicating her.

Lindsay and her ex-husband, Patrick, have sued them in a civil case. And in this criminal case, Lindsay says that by the time she killed her children, she was in psychosis and she should be found not guilty because she is not criminally responsible for what she did. Counting the medical provider today, three medical providers have taken the stand to help the prosecution.

They all say that Lindsey was not in psychosis when they treated her. Lindsey’s lawyer, Kevin Redington, has gone after them hard. He has to. If the jury believes what they say, Lindsey will likely be held criminally responsible. But what you might not realize is that there is a price to be paid for going after witnesses.

It’s one thing to prove that one person wronged you, but it is quite another to prove that a whole group of people did. It’s hard to stay credible when you accuse too many people, it looks like you’re being biased, like like you’re being unfair. So, the beauty of Nurse Paul taking the stand is that the defense did not have to attack her.

She ran a clinic that helped postpartum women. She only saw Lindsey once and then she moved on to a new job. She referred Lindsey to Nurse Rebecca Gelboda who testified most of the day today. That meant the defense did not have to go after Nurse Paul. And in fact, the defense lawyer took the opportunity to do exactly the opposite.

Here’s what he said:

“Obviously a very, very uh dedicated person to this um field, if you will, in in helping people that are pregnant women after they had birth and during that post partum period, right?”

“Correct.”

“And the reason you you were involved with Lindsey is because if I understand it correctly, her mother-in-law, Patrick’s mother, Sue works with a friend of yours.”

“Correct.”

“So, basically Sue asked her friend if she could reach out and have you kind of step in and help out.”

“That’s correct.”

“And then that’s what you did.”

“Yes.”

“And you stepped up and you treated this woman obviously with with care and professionalism. My opinion.”

“Thank you.”

Now, you might be thinking oh, that took the defense absolutely nowhere just saying a few nice things to a witness, but actually it was really important.

The defense lawyer got to essentially say to the jury, I can be reasonable. I will not waste your time. I won’t attack a witness unless I have to. It cost the defense nothing because nurse Paul had nothing negative to say. She just did not have any sufficient amount of information to harm Lindsey and it gave the defense a chance to reset with the jury.

Okay, plunging forward. The next and primary witness of the day was nurse Rebecca Gelata. Nurse Gelata saw Lindsey only three times, twice by telehealth and once in person.

But Lindsey made frequent use of the MyChart function and she wrote nurse Gelata many times. So, those messages are very important for tracking and for understanding Lindsey’s medical journey. Nurse Gelata also prescribed several medications to Lindsey at the same time that other doctors were also prescribing medications to her.

The defense says it’s this cocktail that was exactly what Lindsey did not need. She was bipolar, she was over-medicated with drugs that were calculated to do exactly what they did, which is center over the edge into psychosis. That’s the defense argument. I think the most important point of Nurse Gelata’s testimony was setting out Lindsay’s medical story.

So, I’m going to approach it chronologically, weaving together the direct examination by the prosecution and the cross by the defense based on the timetable. Nurse Gelata did tow the prosecution line on whether Lindsay had mania or psychosis. She insisted that at their first meeting on October 29th, Lindsay did not appear manic and she was not in psychosis.

“And in this meeting on November 29th of 2022, did you observe anything um in which she displayed uh manic symptoms?”

“No.”

“And what traditionally are manic symptoms that you look for?”

“Patient is highly distracted to lots of extraneous stimuli. Um there is um press uh pressured speech, grandiosity. So, like suddenly someone’s like, ‘I’m going to run for office. I’m going to be the president.’ And you’re like, ‘Okay, you’ve never had an interest in that before.’ Um sleep is really poor. Um so, somebody might get like 2 hours of sleep, but be like, ‘Go go go go go.’ Um increased goal-directed activity. So, somebody might be like painting the exterior of their house, painting the interior of their house. They might be, you know, doing a bunch of different projects with no like decompression time or feeling tired.”

“And what would be signs of psychosis usually?”

“Signs of psychosis, they can be sort of subtle. It might look like somebody’s like responding to, you know, stimuli in their in their head, like basic based on the way that their eyes are kind of tracking and they’re not really paying attention. Um they may be quite guarded. Um they may have a delusional thought process. Like for example, they might think that like somebody’s out to get them when there’s really no like basis.”

“And in this first interaction that you had with Lindsey Clancy on 11/29, did she display any psychotic symptoms?”

“No.”

Dr. Gelada treated Lindsey Clancy for less than a month, but throughout that time, Lindsey clearly was getting worse. Dr. Gelada read messages from Lindsey sent from November 30th through December 2nd, and we could see just how chaotic and desperate she seemed across that period of time. In fact, she wrote Dr. Gelada a lot throughout the month that they treated together.

Frankly, many doctors’ offices would have refused to answer so many messages, but we also could see from them just how desperate Lindsey Clancy was.

“Beginning at 7:51 a.m. she sends you a message saying, ‘Hi Rebecca, I took the 15 Remeron and 25 Seroquel. I woke up at 12:00 with horribly intrusive thoughts of wanting it to be all over. I took 1 mg Ativan and went back to sleep and the thoughts went away. Now that I have the Ativan on board, I really need to explore the option that I’m addicted to Ativan. I have a therapy appointment with a teacher in your office. I would really like to speak to with someone in the substance use clinic to explore the option.’ So at 8:51 on December 2nd, you respond to her. Right?”

“I did. I fully appreciate and understand the concern for benzo tolerance. It’s not something I want to happen to my patients ever. That being said, there’s a place for benzodiazepines, especially at the beginning and acute phase of treatment and getting someone stable. And then we would always pull back slowly. I think another thing to try tonight would be to take 50 mg of Seroquel, the two tablets, and see if that works better. Um the intrusive thoughts are part of postpartum depression and anxiety, very painful to think and experience, but I want to reassure you that it’s not uncommon and mean nothing about who you are as a mother.”

These messages, in my view, primarily help the defense. We can see that Lindsey is not drug-seeking. She wants off drugs, particularly addictive ones. And there are also some early hints that Lindsey might be bipolar, and she might be being given the exact wrong medications if she is.

The messages also do show how severe the problems were, and that the problems, particularly the sleep, were triggered when she took an SSRI, Zoloft. Now, that again might suggest that Lindsey is bipolar and should never be on an SSRI. In early December, Lindsey wrote this.

“10:02 you receive a message from her. She says, ‘The insomnia started from the Zoloft, but then after the 2 weeks of daily Ativan and Benadryl use, that’s when the insomnia was at its worst. I’ve tried so many different sleeping aids at this point, trazodone, Ambien, Remeron, Seroquel, and they all seem to barely touch the sleep until I take Ativan with them. So, tonight I will try 15 of Remeron with 50 of Seroquel. I fear that if I wake up in the middle of the night with intrusive thoughts again, I will feel like I need Ativan.’ She um sent another message. It’s kind of cut off, but it’s still within the 10:00 hour, where she adds, ‘I also just feel c- I also just feel concerningly numb right now, like I have no emotion whatsoever. I feel like I’m going to die and I don’t care.’ When she sent that message to you, did you respond back to her at 11:35?”

“I did.”

“And um with the fact that she talked about being numb and having no emotions. Feel like I’m going to die and don’t care. What did you do?”

“I said this sounds like depression and anhedonia symptoms. I would say if you’re feeling unsafe, particularly as we head into the weekend, it is important for you to have information for psych emergency services available to you and I provided um a list of the 24-hour um emergency service programs like mobile crisis intervention.”

The prosecution has suggested that Lindsay caused a good deal of her own problems by the chaotic way she approached her treatment and her medications. She would get a prescription from one provider and decide not to take it. Or she would take it for a few days and then stop it. And she would see one provider and get a prescription and then she would go to another provider and get a different prescription entirely.

The prosecution has strongly suggested that her refusal to choose one doctor and to stick with her medications created a lot of trouble for her and the blame for that lies with Lindsay Clancy, they say. The defense believes that it was giving Lindsay Zoloft and SSRIs that caused her to have such a profound problem in the first place.

On cross-examination, they brought out these points that she only took one full dose of Zoloft. She had taken a smaller taper up amount, but she only took one of the full dosage for one night, but her sleep problems were so severe that it immediately had to be discontinued.

“Now, one of the things that you would mentioned is that it’s important to determine and and you did have thoughts of possibility that she was bipolar. Is that correct?”

“Correct.”

“And one of the things that is contraindicated to someone who does suffer from bipolar, whether it’s one or bipolar two, is that you do not place them on a selective serotonin reuptake inhibitor drug such as Prozac or Zoloft, right?”

“Correct.”

“Because it can have an effect on them, isn’t that right?”

“Correct.”

“What’s the effect it can have on them?”

“It can cause what we consider rapid cycling, meaning you can swing from mania symptoms to depression symptoms relatively rapidly.”

Through November and then into December, the record suggests that Lindsey was in a downward mental spiral.

“It says, ‘Last night I didn’t take Ativan. My dose had been the night before at 1:00 a.m. Only slept about 4 hours at the beginning of the night, about 9:30 to 1:45. Then I dozed off for maybe another 45 minutes, from 4:30 to 5:00. Today all day, I had horrible intrusive thoughts and felt very, excuse me, felt deeply depressed. I finally took a 0.5 of Ativan at 6:00 p.m. and now the thoughts are gone and I feel good.'”

The defense believes that the reason Lindsey couldn’t sleep was the SSRI causing her to cycle between bipolar mania and depression. And actually that occurred to Nurse Gelada also. She told Patrick and Lindsey that she thought it was possible that Lindsey had bipolar disorder. Nurse Gelada said that Lindsey did not meet all the criteria for finding that she actually had bipolar disorder, but she thought it was at least something that might be the case and that they should be thinking about.

“Did what was reported to you rise to the level of diagnostic criteria for bipolar disorder?”

“Not at that time.”

“Okay.”

“And um when you explained this to them, your thoughts about her reactions to the medication and um these reported prior symptoms, did Patrick and Lindsey seem receptive to your diagnosis?”

“I recall Patrick saying, ‘My wife is not bipolar.’ Lindsey looked at me. She did not She did not say anything.”

And Nurse Gelata even wrote again about the issue of whether Lindsey might have bipolar disorder.

“Because you are not tired at all and had a significant reaction to Zoloft at 50 mg. I’m concerned this is an underlying mood and bipolar disorder. I know you and your husband did not necessarily agree with that, but I feel that I’m going to but I’m going to send along this information to review. So, I sent her an a list of symptoms of bipolar risk factors um so that she could have it to refer to.”

And again, at this point, the only symptom she was reporting of mania was this not being able to sleep and not feeling tired, right?

“And yes. And the racing thoughts and the trouble concentrating.”

The defense acknowledged that Nurse Gelata at least was considering what they believed to be the correct diagnosis, unlike the other providers, but they say she never treated it appropriately.

“Still not sleeping. It was It was a huge problem for her, right?”

“Yes.”

“And she told you in her message thing, ‘No, the weird thing is I don’t feel tired at all.'”

“Correct.”

“And that’s one of the things that you had told us earlier is a symptom, correct?”

“Correct.”

“A person that is not getting sleep but doesn’t feel tired.”

“Correct.”

“What is a symptom of?”

“It’s It could It’s a symptom of mania that we look for.”

But the prosecution points out that Lindsey and Patrick did not seem to want to accept a bipolar diagnosis. And so, what exactly were the providers supposed to do if she wouldn’t? At times, both sides seemed to slip into treating this case like it’s a medical malpractice case. It is not. Lindsay is going to ask the jury to find that she is not guilty by reason of not being criminally responsible. The prosecution has to prove that she had the substantial capacity to know that what she did was wrong and to not do it.

She could be capable of knowing that even if she had bipolar disorder and even if every doctor missed that. So, the question is not whether the doctor screwed up, it’s whether Lindsay Clancy remained criminally responsible. So, back though to the very troubling chronology that we’re following, things continued to worsen for Lindsay.

“We discussed that the plan was to taper the volume over the weekend, but they both agreed that Lindsay’s symptoms were too acute. She’s sleeping better, but still waking up with panic symptoms and intrusive thoughts, feels numb, has thoughts of SI, but no plan and no intent. Um I encouraged her to engage with Women and Infants in Rhode Island to complete an intake for a higher partial hospitalization program.”

Nurse Gelada kept bumping up Lindsay’s medications. The defense believes that was the exact wrong thing to do.

“So, at this point with all the providers of your program and her indications as well as her husband’s about the number of times that she had suicidal ideation, um did you prescribe more drugs for her?”

“At this occasion, I prescribed Valium.”

“You bumped her up to Seroquel to 400 mg, didn’t you?”

“Yes.”

“Did that help? How’d that work out?”

“At 200 mg, she was able to sleep. Um so, I felt that the mixed the manic symptoms in her mixed presentation were alleviated at 200.”

Nurse Gelata said that she felt strongly that Lindsey needed to be hospitalized in a partial hospitalization program, basically a day program where Lindsey would go home at night. On November 12th, Nurse Gelata wrote:

“I know this has been brought to your attention several times, but I strongly strongly recommend a partial hospitalization program so that you can get started on utilizing these treatment methods for relief.”

It seems the Plancys may have been reluctant to do that at first, but things got even worse for Lindsey, and Patrick and Lindsey contacted Nurse Gelata on the 15th of December 2022.

“They inform this has been the worst day for Lindsey. Is having persistent intrusive thoughts of suicide, no active plan, but both Lindsey and Patrick agree that higher level of care may be necessary at this time. Discussed options, they state they’re likely to go to MGH ED as they have perinatal psychiatry as well as an inpatient psychiatric unit. Lindsey also deciding about McLean. This writer advised that they keep us posted and sign a ROI release of information so that we can communicate with treatment providers at higher level of care.”

Here’s the saddest detail of all. Lindsey, in fact, went to MGH and then on to the partial hospitalization program, but they refused to accept her. And the why just takes your breath away. As you will see, Nurse Gelata really really did not want to answer the why. I’ve spliced together some of the answers she gave as she attempted not to answer this.

“Was she treated at Women and Infants?”

“I don’t believe so.”

“Why not?”

“I wouldn’t want to speculate I or assume, but it seemed to be her intake appointment.”

“Her what?”

“Her intake appointment. I can’t speak to what happened at Women and Infants.”

“Why not?”

“Because I was not a part of that assessment.”

“What does that mean?”

“I did not see the assessment and I did not speak with Dr. Diaz.”

“Why?”

“Lindsay had informed me that she was going to be at the program for 2 weeks.”

“She was hoping to be at the program for 2 weeks, right?”

“She told me she was going to be at the program for 2 weeks.”

“But she was turned away after about 8 hours of sitting there um in an assessment and sitting in a in a group session and she was turned away because of their concern that she was suffering from Well, let me ask you. What was their diagnosis?”

“I’m not sure.”

“Did you ever find out?”

“I have not.”

“Does it matter to you as a as a treating person that I think your words were is invested in Lindsay Clancy’s care at that time? Did it matter to you why she didn’t get accepted into the program?”

“It did.”

“So, why was it?”

“I I do not know their diagnosis.”

“Did you know that in fact they wouldn’t accept her into the postpartum program because of their concern that she had been over medicated by drugs and they wanted to find out”

“I can’t speak to that.”

“Did you know that she was diagnosed as diagnosis depression due to adverse drug effects?”

“I cannot speak to that.”

The hospital apparently wanted Lindsay taken off all the medication she was on, including the Seroquel that Nurse Gelada had prescribed. The hospital thought these drugs, apparently at least according to the defense, were causing Lindsay’s problems. So, that the partial hospitalization wouldn’t help her until she got off the drugs, and then they could see exactly what she was dealing with.

The fact that Nurse Gelata fought so hard against answering made these facts even worse, because it looked like she felt guilty about it, that she was trying to hide it. To make matters even worse, the hospital said that it tried to reach out to Nurse Gelada to tell her and talk about why they were not accepting Lindsay into the program.

“Of note, we attempted to reach current outpatient provider, Rebecca Gelada, but did not receive a call back.”

“I never received a call from Women & Infants. They never called me. I absolutely would have called them back.”

Overall, it is one of the saddest moments so far, wondering whether this was a missed opportunity if Lindsay Clancy had been taken off all her medications. If Lindsay Clancy had been admitted to the partial hospitalization program, could it have changed the course of three young lives? We will never know the answer to that question, but Nurse Gelada did say, at least according to the notes, that she was not able to supervise Lindsay Clancy going off that Seroquel medicine right away.

“And um what were your thoughts about her report that she was discharged and the recommendation for um tapering the Seroquel or getting off the Seroquel, I should say.”

“I said I’m not opposed to that. However, I’m concerned she discharged you as I do feel you could benefit from the groups and added support separate even from medication changes. In fact, if we’re not going the medication route, I think groups and therapy are the treatment needed as I feel the intrusive thoughts you’ve been having are nonetheless concerning and I know they’ve caused you considerable distress. I’m also on vacation next week, so I’m hesitant to start a taper when I am not available to you for questions and concerns. Again, I’m open to starting a taper, but I want to be available to you as it happens. You mentioned you are connected to your previous psychiatrist. Would that be someone to consult as well?”

And to make matters even more convoluted, it wasn’t just Nurse Gelada who was prescribing medications to Lindsay. Lindsay was simultaneously seeing a psychiatrist who testified yesterday at trial, Dr. Jennifer Tuffs. And Dr. Jennifer Tuffs was also prescribing at the same time. The two were overlapping in caring for Lindsay.

“You knew that she had a a psychiatrist that had been treating her as since end of September, early October, right?”

“I knew that she had a psychiatrist that treated her in September.”

“And who was that?”

“Dr. Tuffs.”

“And did you know that she continued to see Dr. Tuffs through October, November, December, the same time that that she was reaching out to you guys for help, too?”

“I was aware she took the Zoloft in October. I was not aware she was still seeing Dr. Tuffs in November. And I knew she called her in December.”

“You would agree with me that young woman came to you people for help, right?”

“Yes.”

“Okay. And she was very, very forthright. In other words, if you wanted her to sign a HIPAA form, she’d sign it, right?”

“Right.”

“And she would answer your questions to your perspective in an honest fashion.”

“Yes.”

“You didn’t really hide anything.”

“No.”

“Did you talk to Tufts?”

“No.”

“Did you ever get access to Tufts medical records?”

“No.”

“Do you know how many times she saw Dr. Tufts?”

“I do not.”

“Would it surprise you if I told you that she saw Dr. Tufts 14 times in the time frame of October or the end of September, October, November, December, and then January, 4 months.”

“Yes.”

“Uh and that’s 14 times plus the three that she saw you. Is that right?”

“Yes.”

“And that would be within a compressed period of time. I know it’s the last week, I believe, in September, but October, November, December, and then January, right?”

“Yes.”

“And during that period of time, you’re aware that she was provided many, many, many prescriptions for antipsychotics, selective serotonin reuptake inhibitors, benzodiazepines, all of that, right?”

“I’m aware she was prescribed other medications.”

Nurse Gelata helped the defense with a couple of points. First, she made it clear that Lindsay was not drug-seeking. She was, in fact, very afraid of becoming addicted to benzos. And secondly, there’s been some suggestion online that maybe Lindsay was not caring for her children when she went to the gym and left the children with the gym daycare.

But Nurse Gelata testified that Lindsay had used physical activity to ward off some problems after she gave birth to Dawson, her second child. Nurse Gelata actually recommended to her that she exercise. So, today, overall, was a heavy day with the depressing recitation of Lindsay circling ever downward and no one and nothing seeming to be able to stop it.

So, I do want to end with a little bit lighter note because it appears that TikTok has reared its head in the courtroom once again. Lindsay was treated at McLean Hospital. Her husband, Patrick, said, “It wasn’t much in the way of treatment. It was over the New Year’s weekend and they only had a skeleton staff,” he said.

So, the prosecution has argued that the medical records show Lindsay met with all kinds of mental health care professionals while she was there. And so, this impression that Patrick gave that there wasn’t much treatment is just wrong. But, the doctor from McLean who came to testify said she did not actually know who was on staff or not this weekend.

And that is where TikTok comes in because a former nurse from McLean Hospital apparently posted a video saying that McLean was a hospital that was severely understaffed on the weekends. Now, the defense wants to use her as a witness. Here was the judge’s first impression.

“I mean, just so we know where we’re going. I I can’t imagine that that witness would be allowed to give her in a sense review of McLean’s. If it’s five-star and she may say it’s two-star, you know, this is not TripAdvisor. I wouldn’t allow that. But, but, the question seems to be for me a a closer call about what the standard staffing and programs may be available on a holiday weekend. Because the Commonwealth’s witness said, ‘I don’t know that.'”

The judge hasn’t ruled yet. We’ll be following that. Thanks for watching. I will see you tomorrow for day 12 of the Lindsay Clancy trial.”