“My Wife Is Not Bipolar” Nurse Testifies & All The Signs of Possible Hypomania Discussed in Court

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1:19November 16th, 2022. Lindsay goes to the South Shore Emergency Department. This is the same hospital that she gets sent to January 24th before she's med flighted. Okay. So November 16th, she goes into the emergency department and she's like, I have severe insomnia. She is prescribed Chazodone at 50 milligrams for sleep. She takes it home. She doesn't stay. She's not like inpatient. She just goes to the emergency room. She gets a prescription and she later reports to Dr. Tufts that she went to the emergency room, got Chazodone and it had very minimal effects on her. Two days after this emergency room visit, November 18th.

1:57She writes in her journal, Tree of Life Journal. It's like I'm so desperate to get a mental break from taking care of everyone that my mind is trying to make something physically wrong with me. My mind never shuts off. It's constantly thinking of the next thing someone needs. I can't shut it off. I desperately want to go back to work, but now I don't know how to function and it worries me. Now that we're in the month of November, the medication switching gets really fast and from there December does not get any better at least in my opinion it would appear that November and December Lindsay is going through a very active rapidly changing psychiatric treatment period so from September 15th 2022 to January 23rd there are approximately 35 prescription dosage changes taper or treatment plan events that involve 13 core psychiatric medications.

2:48So it's like 13 medicine and then they're like, okay, well, let's ramp it up. Let's decrease the dosage. Let's swap. And it's 35 different plans. So you have Zoloft SSRI. You have Ativan, which is a benzodiazepine. Hydroxyzine, which is like a prescription antihistamine to replace the Benadryl. Boost Bar, anxiety medication. Trazodone, an antidepressant. Prozac, a different an SSRI, Ambien, a sedative sleep medication, Remarin, an antidepressant, Klonopin, a benzodiazepine, Seroquel, antipsychotic, Valium, another benzodiazepine, Lamictal, an anticonvulsant and mood stabilizer, as well as Elevil, which is an antidepressant.

3:29We literally have a cocktail of antidepressants, benzodiazepines, sleep medications, antipsychotic mood medication, and a mood stabilizer moving in and out of Lindsay's med regimen. Now, I'm not saying they're moving in and out of Lindsay, but it's a constant up and down increase, decrease with the dosage, and she's clearly not getting better. Thanksgiving 2022, two months before the Clancy children are killed, Lindsay is showing signs of depression. Her husband Patrick takes the stand, and there's going to be a lot more on Thanksgiving in the next part because there's a lot on Thanksgiving, but he's being asked about Thanksgiving.

4:06What was Lindsay like? She wasn't talking much. She had low energy. She was really depressed. I just remember when she showed up, um, my sister-in-law gave her a big hug and, um, she was able to get through dinner, eat dinner with everyone. Yeah. And when she told you she was suicidal, did you ask her if she had a plan on how to kill herself? Yes. And what was her response? She said no. And at some point in time, did she tell you that this was the first time she was having these thoughts? I don't know if she mentioned it was her first time or not. I just remember saying she had them. Patrick's mom, Sue Clancy, more on her later as well, is also a nurse.

4:49She works at South Shore Hospital. So this is, again, the same hospital. The same what? Yeah, she is. So Lindsay is, well, she was a nurse, a labor and delivery nurse at Mass General. but she gets taken to South Shore and Sue Clancy works at South Shore in labor and delivery and she recommends Lindsay to see a woman named Julie Paul. Julie Paul works at South Shore. She's a psychiatric mental health nurse practitioner who can prescribe. She is board certified and this alone... Wait, hold on. This is so crazy. Yeah. Patrick's mom is a delivery nurse? Labor and delivery nurse and his new wife is also...

5:25She is in the... Oh my God. She's an REI. So there's just like a lot of... whoa yeah she must know so you know like this is kind of her life dealing with women that's dealing with people who give birth yes yeah yeah wow so she recommends her to see julie paul and she is a board certified nurse practitioner this has spawned a new debate like i'm telling you every single fucking thing that we talk about is a freaking debate online and it's it's just so heated there's now a whole debate on nurse practitioners should they be allowed to prescribe okay and like there's a whole okay what happened it just because nurse practitioners have i would say probably less academic training for prescribing in the field that they are prescribing what's her julie julie paul is a nurse practitioner and she prescribed something yes but more so later there's another nurse practitioner that enters the conversation.

6:26And so now there's a whole debate on Reddit forums of, you know, MDs, doctors saying like, we should never let nurse practitioners fucking prescribe shit. And then nurse practitioners be like, yeah, well, we should. And then there's who cares more about the patient? And that itself is a huge beast of a conversation that, again, I'm not in healthcare. I've never worked a day in healthcare in my life. So I really have no say. But, you know, but I'm just saying it's out there. That conversation is out there. So she's like, maybe you should see Julie Paul. Julie Paul is the director of the Perinatal Behavioral Health Program at South Shore, which specializes in pregnancy and postpartum.

7:01Now, Julie Paul is, well, she was, and this is a misconception out there, she was one of the few providers not being named in the lawsuit by Lindsay or Patrick, but I believe she is now listed as a defendant in one of the civil suits. So there was a lot of, I think, praise for Julie Paul during her testimony knowing that she was not being sued by either of the Clancy's but um I don't know there's just yeah it's like a moving mess right Julie Paul reaches out to Lindsay after Sue Clancy refers her but I would say that Julie Paul is one of the more liked healthcare professionals November 2022 Julie Paul starts asking calls Lindsay asks about Callan's birth and Julie testifies.

7:50She said that she did really well for the first 12 weeks. She was excited, really happy, and then Patrick went back to work and she said she started to struggle with some anxiety. Lindsay expresses to Julie that she was concerned about Ativan and Benadryl. Julie says she'd been taking it for two weeks and it was working really well, the Ativan, the Benzo, but she was getting concerned about dependence so she self-weaned herself off of that. she reports to julie feeling overwhelmed now having three children but she experienced this to some extent with her second pregnancy with dawson and nurse julie wants to put lindsey on prozac which is an ssri because lindsey had told her that way back in nursing school she had actually taken prozac before and she didn't really have any crazy symptoms or side effects from prozac other than sexual side effects but you know that's not the biggest problem right now right So she's like, instead of just trying other SSRIs, let's try Prozac.

8:47Like this is a known medication to you. Rather than taking shots in the dark, this is a good start. Now Prozac is, again, another SSRI that we are prescribing to someone who may have an underlying bipolar disorder that is not counteracted with any other mood stabilizer or anything else. Just straight Prozac, just like it was straight Zoloft. So she prescribes Prozac 10 milligrams for the first four days and then increase it to 20 milligrams if tolerated. This is November 22nd that Lindsay says she starts Prozac. She's on Prozac. And Nurse Julie also still says you can take the Ativan when you have severe anxiety.

9:23But the plan is let's still taper off the Ativan, right? And let's move towards something like Boost Bar, which is not a benzo. It's anti-anxiety medication. Much safer. Well, I don't want to say safer, but much less risk of dependency. That same day, November 22nd, 2022, Lindsay writes in her Tree of Life journal. What is it called Tree of Life? Yeah, it's like a Tree of Life. The name is on there? Affirmations. I am calm. I will remain calm today. There is nothing that needs to be on my mind. The weight is lifted from my mind. I will sleep tonight. Julie also sets up talk therapy with Lindsay with Letitia Dukes but the same day that all of this is happening Julie gets a message from Lindsay on MyChart which is how she talks to her it's like a provider to patient communication platform and it reads hi Julie this is Lindsay Clancy I'm sorry to contact you like this but when you have a minute can you please call so Lindsay in her talk and Lindsay expresses concern about starting the Prozac they have a conversation Lindsay states to Julie that okay fine I will be starting the Prozac but a few days later Lindsay tells her that she doesn't like the Prozac Julie testifies she wasn't tolerating the Prozac so we had a conversation about stopping the Prozac she was having a really hard time sleeping so I gave her a one-time dose of Ambien Ambien is a very strong sedative for usually very severe cases of insomnia, but this is a one-time dose.

10:53But I think a lot of people just see Ambien on a list of medications and are like, oh my God, Ambien on top of the benzos, it's a lot. And I'm not saying that her list of medications is not a lot, but it is a one-time dose. The next day, November 23rd, 2022, Lindsay journals, I slept well last night. I will sleep again tonight. Today will be a great day. I will go back to work on Sunday. I will thrive. I can feel like myself again. I'm grateful for Sue, Patrick's mom, who is always listening and trying her best to help me Kids are sleeping great for Pat Pat is handling nighttime stuff I'm grateful for Julie for making a plan for me A big thing is I feel disconnected with myself Time, reality I think going back to work will help with that After Lindsay stops Prozac After reporting to feel, quote, disconnected, out of it, spacey Julie Paul prescribes Remarin which is an antidepressant with very significant sedating effects so it more so can help with sleep and anxiety.

11:55A lot of people report getting deep sleep with Remarin though a side effect is feeling a bit groggier in the mornings but Julie Paul also prescribes Klonopin. Klonopin is another benzodiazepine but it's a much longer acting benzo compared to Ativan. And it appears that there is kind of like a less risk of dependence there. This is where people think it starts getting reckless. So when you have a benzodiazepine prescription and you get another one to replace it, you're not turning in your previous benzos. You still have them. You're supposed to have compliance. The patient has to show compliance of like, okay, I'm just going to switch, right?

12:36But they think there's too many benzodiazepine prescriptions going out nonstop. And this is just one of the many that's going to continue just different forms of benzodiazepines. So we're switching from Ativan to Klonopin. Now, Julie Paul does argue that she wanted to switch to Klonopin because Ativan was giving Lindsay rebound anxiety. So when it wears off, the anxiety comes back tenfold, which makes her wants to take more Ativan probably. So Klonopin, it has a longer half-life. It's a, you know, you're not going to feel as much of that rebound anxiety as what people report so she wants to replace the Ativan with Klonopin.

13:12Lindsay reports that with the Remarin and Klonopin together she did sleep on and off until about 3 45 a.m which isn't great but it seems like this is better than what she's been dealing with. Lindsay asked Julie Paul if maybe she should up the dosage of the Remarin so not the benzo the you know Remarin the antidepressant she's like would that help with sleep because it's an antidepressant with you know sedative effects sedating effects right julie paul gives her the okay let's trial an up dosage of remarin which does end up helping lindsey sleep but she reports that she's felt super disconnected with herself and reality and this is again a very common report for people with remarin um on reddit that i could find and she said that it was a very scary feeling so lindsey asks after two nights if she can stop the klonopin which paul approves so next day we've stopped the klonopin lindsey has a full panic attack okay julie paul instructs her take the ativan so stop the klonopin take the ativan and again klonopin is prescribed as needed so these are both benzos but like don't take the klonopin take the ativan and she's like go for a run because running always helps lindsey with regulating her anxiety julie also suggests partial hospitalization programs but she says that lindsey told her it it didn't feel like it was going to work logistically for her and her family.

14:31But this is the first time that we see a provider see that Lindsay's situation may need more intensive treatment than just normal outpatient medication appointments and therapy sessions. Then there's Letitia Dukes. Letitia Dukes is a therapist, so she's not a prescriber, which also means I don't think, I think she might have been recently added into one of the lawsuits. But she is, she's not dealing with the medications. She is aware of the medications. She also works herself short that's why julie paul recommended her she's aware of the medications but mainly this is talk therapy cognitive behavior therapy cbt therapy right duke says her presenting concerns were anxiety lack of sleep depression symptoms frequent passive si thoughts of wanting to no longer exist you know at one point this is where i think like the commonwealth really is not doing itself a favor um i do think the commonwealth did a shit job at even preparing these prescribers for testimony okay how so they just like i mean none of them really know how to answer questions in a way that is seems favorable to the jury it just a lot of people keep saying like the commonwealth is doing the defense's job and i would have to agree at certain points because it's just just their lawyering does not seem that great at one point the commonwealth this is their witness okay a very important witness at that the commonwealth asks letitia dukes as far as your role as a social worker do you often get into the weeds with patients about their medication letitia dukes is like i'm not a social worker i'm a mental health counselor but yes i typically have an overview of medications but i don't particularly get into prescribing or how to take medications And again, this is just another example of like, this is your own witness.

16:20You don't seem razor sharp. What's happening? And this is what? We're only like a week or two into trial? Heading into December, Lindsay reports to Letitia Dukes that she has low mood and feels numb. Dukes notes, she was tearful when discussing her anxiety symptoms. She reported as far as passive thoughts were thoughts of not wanting to be here or no longer wanting to live, but no plan. December 5th, Letitia Dukes says, she reported that over the weekend, she had a difficult weekend having intrusive thoughts about wanting to and she contacted Aspire Crisis Support a hotline. She met with the clinician virtually and was told that she did not meet the criteria for inpatient treatment due to having no SI plan.

17:02She reports that she did not see signs of mania or signs of delusion or paranoia and no signs of psychosis but according to Duke's notes she also says feels like she's going to die but she doesn't care if she dies feels like she's going to die but doesn't care she then talked about how the meds she's on were not helping her sleep yesterday she took ativan due to intrusive si thoughts she was constantly worried something was going to happen to her children or something bad was going to happen to the baby she reported she talks about her anxiety all the time with her mom husband and mother-in-law duke says that lindsay reported being uninterested in topics from friends, lack of interest in conversations.

17:42Lindsay told Dukes that she just feels numb, lack of attention, confusion. She's only sleeping two to four hours a night, which is very alarming. Dukes notes that Lindsay's facial expressions show anxiety, fear, apprehension, and sadness. Dukes meets with Lindsay four times in December, but largely nothing explosive comes out of Duke's notes nor her testimony. And while Lindsay is meeting up with Letitia Dukes, Julie Paul transfers Lindsay's care to Rebecca Gelata. Julie Paul is leaving the practice and she's moving to New Hampshire. So she introduces Lindsay to Gelata and she has been working at, Gelata has been working at this clinic for about two years.

18:21So this is all South Shore hospital kind of system. Lindsay's first appointment with Gelata is November 29th and Gelata starts her on Seroquel at 25 milligrams. So the plan originally was to just get Lindsay on there for maybe about four-week period for sleep and anxiety, but later Gelata starts considering it for longer-term mood stabilization, possible bipolar spectrum treatment. Now, side note, so far, most of the meds Lindsay has been prescribed are antidepressants and anxiety medications. Seroquel is considered an antipsychotic medication used typically to treat schizophrenia, bipolar disorder, but also major depressive disorder.

19:01So Gelata is saying like, when I started on the Seroquel, it was more so for the major depressive disorder but then i'm like wait i feel like there could be an underlying bipolar disorder and maybe we need to take the seroquel for that instead the bipolar conversation gets big here because gelada straight up says she considers that lindsey was bipolar however she does not meet the diagnosing like the diagnostic criteria interesting so same time she's still seeing the first doctor through telehealth the whole time and are they double prescribing her the meds are they communicating do they know what's going on with each other gelada and tufts never communicate they do not get each other's records both of them argue that lindsey was self-reporting to both of them what the other was prescribing and they did not feel that there was any overlap in medications is what they're saying fx's american horror story returns for an unrivaled 13th installment with the iconic horrors you love to fear and an all-star cast reprising fan favorite roles.

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22:36Now, when Gelata takes the stand, a lot of people online don't like her. They don't like her and they don't like Tufts. Those are the two very controversial people. Tufts gets really defensive later, so that's one thing. gelada is i think people are kind of off put by her demeanor she's incredibly smiley almost has a playful energy to her and maybe that could be her high-pitched voice which i can relate to and i'm also someone that likes to smile in very nerve-wracking particularly high-risk situations where you do have to be very professional but i think it's more so her tone and cadence so she's asked like how do you spell your last name for the record and again she is someone she's a nurse practitioner that specializes in helping people who are in dark places in life so perhaps she's accustomed to talking in such a way that comes off super friendly but you know when you are a witness on a murder trial and there are three young children it just comes off maybe a little unsettling how do you spell your last name for the record j-o-l-o-t-t-a what kind of training and education did you do in order to become a psychiatric nurse practitioner?

23:45I have my bachelor's degree from the University of Connecticut in allied health sciences and then I went on to get my master's actually in counseling psychology in 2013. Gelata is asked if a patient needs a higher level of care, is it common to make referrals for those patients? Gelata does admit that it is pretty common practice and that is like a huge debate online. Tufts, one and a half months into being a practicing psychiatrist. Should she have referred Lindsay to someone that could provide the care that Lindsay probably needed? Gelata, nurse practitioner. Should she have referred Lindsay to someone who could provide the care that she needed?

24:30Because you are also, again, not just talking about someone who might have an underlying bipolar diagnosis. You're talking about someone who is in that very sensitive postpartum time bracket. So a lot of things are happening. Gelata says when Lindsay came in, she expressed her concern about becoming dependent on benzodiazepines. And this is like a huge thing. So the Commonwealth, they kind of hint at the fact that Lindsay was doctor shopping. And they think that Lindsay was doctor shopping for benzodiazepines. We'll get there. But as for benzodiazepine dependence, Gelata says she's concerned about taking benzo.

25:06she had mentioned something called rebound anxiety. What that is is once the dose wears off your anxiety goes above your baseline once the dose of the benzodiazepine wears off. If she's taking it in the middle of the night the next morning she would feel more anxious. I was concerned about that. She was concerned about getting physically dependent on it because she had needed to take it for a number of nights. Gelata starts her treatment plan which includes switching out the Ativan for Valium. So we go from Ativan. Julie Paul says let's switch to Klonopin because it's a longer half-life, less, you know, rebound anxiety.

25:39Then she has a panic attack. Okay, back to Ativan. Now she's transferred to Gelata and Gelata is like, you know what, let's stop the Ativan and go for Valium. They're all different types of benzodiazepines. They do work differently, but they're all benzos. She says the idea is Valium, kind of like the Klonopin, stays active in the body much longer than Ativan. So the rebound anxiety would probably be less with Valium. And again, Valium and Klonopin are different. So maybe she would react better to the Valium, you know. Now, Seroquel is the huge conversation. So again, she first prescribes it more as a mood stabilizer for major depression.

26:14But later, Gelata thinks it could be possible bipolar spectrum treatment. Lindsay does not like the Seroquel. The civil complaint attributes worsening intrusive thoughts and self-exit thoughts and auditory type experiences to the period following Seroquel. Now, I know a lot of people who think that Lindsay does have bipolar disorder 2, they think it's strange that she did not react well to the Seroquel, but this is also pretty common. Not every SSRI is going to react the same with every patient. Not everyone with bipolar 2 is going to react to Seroquel in a certain way. But it's, I think the fact the conversation is like, did we know that she had an underlying diagnosis or not, right, is more so the conversation.

26:50But Gelata is asked by the Commonwealth, what did Lindsay Clancy express to you as far as Seroquel? Did she want to continue with that? No. Did she explain why? So she felt like when she took Remarin and Seroquel together, she felt weighed down and exhausted, but her mind was still awake and alert, and she didn't seem to think that there was a benefit of being on it. And did she express to you a desire to want to get back to trialing Prozac? Both Lindsay and her husband expressed that that was their preference, which, okay, this is where Patrick seems to get the most involved with Lindsay's treatment.

27:25He does meet up with Gelata, and he tells Gelata that his wife is not bipolar. So that is what Gelata reports in court. And there's a lot of conversation around that. Wait, Patrick tags along once that we know of and tells her that she's not bipolar. Yes, but he also tells her like all these medications, well, from his account is like all these medications are turning Lindsay into a zombie. Like, can we just stop and start fresh? Like stop all these medications and start fresh. Now, I will say to kind of point all aspects of this case for someone that's not in health care, that could be a very reasonable request because it's like, gosh, these are so many prescriptions coming in and out.

28:10Like, can we just like please slow down? It seems so rushed. Others are saying, well, his mother is a nurse and Lindsay's a nurse. It's you can't really just say everyone stop for how long. And then I think more than that, though, I think people can see both ways for that. I think people don't like the fact that he said that my wife is not bipolar. So December 6th, Lindsay comes to see Gelata with Patrick and the Commonwealth asked Gelata, now when you met with Lindsay and Patrick on December 6th, did she or did they report why Patrick was there? I don't recall if they indicated why he was there.

28:41I understood it to mean he was there to provide collateral and support for her. Collateral being extra information. So this is also another huge thing. Reddington keeps pointing out to the other prescribers, especially Tufts, why didn't you call her husband? Why didn't you call Patrick Clancy? Why didn't you call her mom? You knew her mom came to stay with her because she was going through a rough time. Why didn't you call these people? Because you need collateral information, usually for psychiatric patients that you're concerned about because they might not be reporting to you correctly. So it's better to get a third-party perspective to know exactly how they are behaving and what they are going through to add to the treatment.

29:22Now a lot of healthcare professionals push back saying there's just not time and to insinuate that you need to reach out to an adult's parents is very difficult and unfeasible unless you see some glaring red flags, which it does not appear that the clinical presentation in Lindsay's case was a glaring red flag. That is a huge argument, right? I don't know. But the Commonwealth continues with Jalada. Did you express to Ms. Clancy thoughts that you had about her diagnosis based on your interactions over the last few weeks? I did. And what was that? I discussed with her and her husband the possibility of potentially an underlying bipolar disorder.

29:57I based this on several factors, one of them being that she had such what we call an inactivating response to the Zoloft. It's unusual for somebody to describe taking Zoloft and then going 48 hours without sleep and not being tired. So that raised my clinical suspicion a bit. and she had been, I would say, having difficulty tolerating other antidepressant medications that we had been trying to have her take since then. So again, I'm wondering if it's because potentially there might be an underlying what we call a mood disorder, bipolar disorder. There's bipolar 1 and bipolar 2. Both have mania symptoms as part of the diagnosis.