“I Worked At Lindsay Clancy’s Psychiatric Ward. Here’s My Thoughts.” - Dr K HealthyGamer
CChris Williamson
정신 건강임신/출산결혼/가정생활
스크립트
00:00:00Lindsay Clancy case. Give me some thoughts. Okay. So let's start with some background for
00:00:05people who don't know who Lindsay Clancy is. So Lindsay Clancy is an obstetric nurse. Okay.
00:00:12Who has, is married and has three children, has a history of psychiatric illness.
00:00:19And after her third child has a psychiatric decline that is characterized by
00:00:26outpatient care, partial hospitalization program, going to the emergency room, being hospitalized
00:00:37inpatient, being discharged, has seven psychiatric providers, psychiatrists and nurse practitioners
00:00:45who prescribed 13 medications over some period of time. So Lindsay Clancy is also like particularly
00:00:52close to home because I trained at MGH where she went to the emergency room. Um, I know the people
00:00:58who took care of her when she was hospitalized at McLean. So I'm, I'm very familiar with like
00:01:02the, the, this case. Okay. Um, I used to take, she's from Duxbury where I used to take my wife
00:01:09when she was pregnant. There's a beautiful beach over there in Great Oysters. So, and then what
00:01:15happened is, is Lindsay Clancy, um, killed her children and then jumped out of a window and,
00:01:23um, cut herself first, cut herself and then jumped out of a window and is now, I believe,
00:01:27paralyzed for the sternum down. A few months after this happened, I believe her husband divorced her
00:01:32and I think he's in a new relationship. I'm not a hundred percent sure. And then there are two
00:01:37separate legal proceedings. One is the state of Massachusetts is, is trying to, it, it, Lindsay
00:01:46Clancy is on trial and a criminal trial by the state of Massachusetts for murder of her three
00:01:51children. There is a separate civil lawsuit, uh, by Lindsay put forward by Lindsay Clancy and her
00:02:00ex-husband suing various mental health providers for failure to do their duty of care.
00:02:05I didn't know about the second one. That's fascinating. Okay.
00:02:07Yeah. So first thing is most people don't know much about, like, like you said, have you read
00:02:11the legal proceedings? I I've read some of the legal stuff, but I don't know anything about ethics or
00:02:15legality, but I know a lot about medicine and I know a lot about the internet and I know a lot
00:02:19about how people react to it. So there are a couple of things that are like, so this is a thing that,
00:02:27so this is the, these are the facts. Okay. Then there's the internet's reaction to it,
00:02:32which is people are blown away that she has, has, so I heard, this is not something I verified
00:02:41myself, that her husband started a GoFundMe that raised $1.7 million that is not being used for
00:02:49her, her legal defense. I don't know if that's true or not, or if that's social media conspiracy
00:02:55hat. There is a GoFundMe for about a million dollars now, I think. I don't know whether she-
00:02:59She started a GoFundMe to which, uh, women have raised a million dollars on her behalf.
00:03:05And then the other really interesting thing is that this is tearing apart couples. So not just
00:03:14gender dynamics. So someone called off a wedding. So yeah. So someone called off a wedding. So
00:03:18I am a psychiatrist who has done some postpartum work. And I went to the Massachusetts General
00:03:27Hospital and trained at Harvard Medical School. And I am reading 28-page civil proceedings on this,
00:03:35as well as doing a lot of research on postpartum psychosis. And my wife, who is my boss,
00:03:43comes to me one day and she says, I'm disappointed in you. And I said, for what? She says, for how
00:03:51you're handling the Lindsay Clancy case. And I mean, like, what do you mean how I'm handling? Like,
00:03:55I'm, I'm reading things. I'm like reading papers. I'm looking at stuff. And she was like disappointed.
00:04:00I was just blown away. Like this is like, like I took paternity leave. I changed diapers. Like,
00:04:05I'm pretty sure I'm a pretty good husband. I'm pretty sure I'm a pretty good dad.
00:04:09And I'm pretty sure that I like support women through pregnancy. And I've seen postpartum
00:04:13psychosis. We'll get into that in a second. I've helped women through this. And I was just blown
00:04:17away by like my, my wife's reaction. She wasn't like super mean about it. She was just like,
00:04:22you know, I'm really disappointed in you. And I was like, what the fuck? Like, what did I do?
00:04:27Like, I'm actually like doing like what, like I've spent 10 to 15 hours at least like getting into
00:04:35the details of what is going on. And like, so I was just struck by that. And I was like, wait,
00:04:43what, what is going on? Right. Cause I, I know that she doesn't think I'm a bad person or bad
00:04:49psychiatrist or, or things like that. Like I've helped some of her people in her life who have
00:04:55gone through somewhat similar things. So like, I know I'm not like in the wrong.
00:05:01And, and, and so there's just so much energy around this. And then, so what people are getting
00:05:06upset about, right? So people are breaking up over this and a lot of people are like really upset.
00:05:14So, so people, people are upset with, people are upset at the women for supporting Lindsay
00:05:22and not considering the kids. Okay. So.
00:05:25And people are upset at them for supporting the woman full stop, which is a separate thing.
00:05:30Yeah. So, so, so, so let's understand a couple of things.
00:05:35So I think the basic issue here is that it's really a lack of understanding for a lot of things.
00:05:41The first is I don't think men or even society as a whole understands how hard pregnancy in the
00:05:49postpartum period is. Like we all say it's hard, but we don't understand. So the reason that like my
00:05:57take, this is some hot takes and I'm not, you know, I'm not really an expert actually.
00:06:01I think the reason that so many people are rallying to their defense is because.
00:06:06Who's defense?
00:06:07Lindsay Clancy's defense. And reason there are so many women are giving her money
00:06:11is because they have, they have looked down from the cliff that she jumped off of.
00:06:17So I think so many women have had such terrible postpartum experiences, including struggling
00:06:26with thoughts of suicide or even killing their kids or all other things. So I think the experience
00:06:31of, of many women in not even the postpartum period, this is prepartum and there's all kinds
00:06:35of stuff. But like, it is like you are fighting against something that is going to kill your kids
00:06:42and you love your kids and you're fighting against it day after day, after day, after day,
00:06:47and you're losing and you don't know what to do. And it's like, everything is falling apart
00:06:51around you and you like, you don't know what to do and everything's just going to fucking fall
00:06:54apart. I know that's hard to understand, but that that's like, I think that's why people are
00:06:59supporting her because they know what it's like and they know how dangerously close they came
00:07:06to succumbing to this. So let's talk about what this is. So this is the other thing is,
00:07:14you know, I, I, you know, the, the people who are breaking up with their girlfriends and or
00:07:18boyfriends, husbands, whatever. A big part of this is she killed her kids. If you support her,
00:07:23there's no way I can maintain a relationship with you because like, I can't, how can you support
00:07:27someone who would kill their kids? I cannot be in a relationship with someone for the safety of my
00:07:34own children. I think this speaks to a real misunderstanding of what psychosis is. So
00:07:41interestingly enough, mental health awareness has increased, but mental health ignorance has also
00:07:49skyrocketed. So people are aware of mental health, but they don't know what mental illness is. And
00:07:55people don't know what psychosis is. Okay. So let's go through some stats. Two to three women out
00:08:04of 10,000 live births will experience postpartum psychosis. But postpartum depression is
00:08:11experiencing depression within 12 months of having a baby. So not all postpartum depression is
00:08:18necessarily due to the pregnancy. The diagnostic criteria for postpartum depression is the same
00:08:23as a regular depressive episode. It's just, it happens postpartum. Okay. So then there's a couple of
00:08:31other statistics. So, um, there are, I think 6,000 live births. Oh, maybe I'm getting this wrong.
00:08:466,000 or 60,000 live births per day in the U S. Okay. So I remember like doing this math and thinking
00:08:54like a handful of people experience postpartum psychosis every day in the U S the way that the math works
00:09:00out. So the, you're going to have a kid and at some point in the next 12 months, they're going to go
00:09:03into it. Yeah. So, so people are experiencing postpartum psychosis like every day, like all the time.
00:09:07Okay. So it's actually like quite common. It's prevalent. Um, and so, and then the second thing
00:09:15is I don't think people understand what psychosis is. So what psychosis, the best way I I'd explain
00:09:23it is like, you know, like your mind tells you to do things and there are some things that it tells
00:09:28you to do that you listen to and some things that it tells you to do that you don't listen to.
00:09:34So let's take something really basic. Like, let's say, you know, like when you take a dump and you
00:09:41wipe and you don't like wipe good enough and you like need a second wipe. And it's just so natural
00:09:46to like wipe a second time. Right. It's like so simple. It's not even something that you would
00:09:50argue against. You never even question it. Imagine the thought is kill your children and you just do it.
00:09:58So the thing about psychosis is it is like literally like your mind is manufacturing. So what is psychosis?
00:10:05It's a break from reality that is usually involves two or three different things. One is hallucinations.
00:10:10So your mind is literally creating things that are chasing you that you think are real.
00:10:17Linda Glancy said a man's voice told her to kill her children.
00:10:20We'll get to that in a second. So I had a patient once who jumped out of a third story window,
00:10:24was also broke both of his legs. Thankfully, he wasn't paralyzed because he was being chased by
00:10:29a demon. And like imagine a horror movie, but like you're inside it and the demon is real and is like
00:10:36chasing you like you believe it's real. That's what psychosis is. Everyone's like mentally ill
00:10:40by reason of mental defect. And this based on the media is like something that sociopaths do.
00:10:45They pretend to be crazy. Oh, it's a dissociative fugue. It was multiple personalities. It wasn't me.
00:10:49Now, psychosis is a whole different ballgame, right? This is the thing that causes people,
00:10:53including herself to jump out of windows. She's paralyzed for life. Okay. It can also include
00:10:59things like delusions. So this is a different kind of delusional disorder is different from
00:11:04from acute psychosis, but it sounds like she was experiencing acute psychosis, acute psychosis.
00:11:09And there can also be there's like severity of psychosis. So it's not all the same.
00:11:13So when you get persecutory hallucinations, that is more common and actually less severe.
00:11:21So this is a voice actually talking to you. It's not a voice in, I mean, we talk about it like it's
00:11:25a voice in your head. No, it is someone who follows you around and just constantly calls you a piece of
00:11:30shit. Just wherever you go, think about the most toxic. We talked about cutting out toxic parents.
00:11:35Think about the most toxic person, you know, and just imagine that you had AirPods in your ear
00:11:40and they were just commentating on whatever you do. Interesting that the categorization is
00:11:44persecutory. Like that this is the defining characteristic of this guy. They're not following
00:11:49you around going, dude, you look so great today. No, no, no, they're not. Yeah. It's persecutory,
00:11:52right? That's interesting. So, and then what's even more severe than that is command auditory
00:11:57hallucinations. So command auditory hallucinations is there's someone in your ear that's giving you
00:12:02commands. So this isn't thoughts. Okay. This is like commands that sometimes people feel compelled to
00:12:09obey. And in my experience, and I've worked with a lot of psychosis. I trained at McLean Hospital.
00:12:15McLean is amazing. It's like where she was hospitalized. And so the cool thing about McLean
00:12:19is most hospitals will have a psychiatric floor. McLean is a psychiatric hospital. All the floors
00:12:25are different kinds of psychiatry. So when we do, when I rotate, there's a unit there called AB2.
00:12:31Three months on AB2 is bipolar disorder and psychosis. So every patient that I see every day for 90 days,
00:12:37not to mention all the days that I'm on call and covering the unit is all psychosis.
00:12:42So command auditory hallucinations are more severe. And they like, and the whole point of like,
00:12:47like this level of, of psychosis is that the reason we can, we hospitalize people against their will
00:12:55is because we know from a medical perspective that these people, this is what's kind of interesting.
00:13:04It's not even that they can't control it. It's that they start to believe it.
00:13:11Right. So like, like, like, like this is what's really hard for people to understand.
00:13:17It's not about control. It's about belief. So psychosis makes you believe something. So when I was an
00:13:24intern at MGH, I was on my first month of inpatient in this patient. I mean, I don't think there's
00:13:30anything identifying here. It's chimerical. Okay. Patient comes up to me. I, she's not my patient. I'm not
00:13:37taking care of her. I pass her in the hall and she says, how are you doing today, son? And I say,
00:13:43I'm doing well. She's like, you know, you're my son, right? And I'm like, I'm not your son. And then
00:13:48we, we like have this little back and forth in the hallway. And then she's like, get a DNA test.
00:13:53Then you'll know. She's like 10 years older than I am. I'm like, all right, lady, whatever.
00:14:00So I come back the next day and she's like, how are you doing, son? I'm like, I'm not your son.
00:14:06She's like, did you get the DNA test? And I was like, no. She's like, see, I knew you wouldn't.
00:14:14You get the DNA test, then you'll know. And for the rest of the hospitalization,
00:14:18she was sure that I was her son. And I'm not going to get a DNA, like, I'm not going to go get a DNA
00:14:23test to, and then I have to get her DNA, which like, I, I'm not, you know, that's not even possible.
00:14:27It's not ethical, whatever. And she really believes that she had a delusional disorder where she would just
00:14:32think people were her son. And she really believes that. And, you know, and then like,
00:14:36as I denied that I was her son, she like forgave me. And she's like, you know, even if you don't
00:14:41accept it, like, you know, you should really get it. And then you'll know. But like, if you don't know,
00:14:44like, I love you no matter what, yeah, she's a great mom. Great mom. Right. So this is what
00:14:49people don't understand about like psychosis is you take the things that you really believe,
00:14:54and then you just change them. Yeah. Yeah. So there is an element of volition
00:14:59in there. You're following something. It's not derangement. It's, uh, uh, it's deranged belief.
00:15:06And then downstream from that, you are, you're not doing crazy things. The things that you do are crazy,
00:15:11but the beliefs that you have are completely logical to you. Yeah. But, and the beliefs are
00:15:17or break from reality. Yeah. Right. So, so you believe, and, and, and so there, there are,
00:15:22there all are, there is an element of loss of volition as well with command auditory hallucinations,
00:15:27for sure. Right. So, so that's kind of intrusive and yeah. Yeah. And then, then you feel like you can't
00:15:32resist. Right. And so, or you resist for so long and then all it takes is one moment for you to like,
00:15:40follow the command. And then you feel like you can't resist anymore, or you choose to follow because
00:15:44you think it's the right thing to do. We don't know. I wasn't a doctor. I wasn't there. Right.
00:15:48This is, I'm just talking about psychosis in general.
00:15:50So, everyone's like, oh, mental illness. Like there's some, this is what people don't get about
00:15:57psychosis. There's some preservation of agency in every other diagnosis. Right. But this is why
00:16:05psychosis is like, you know, by reason, not guilty by reason of mental defect. I'm not a forensic
00:16:11psychiatrist, but I think that this is the situation for which that exception exists.
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