Jodie Picoult - Plain Truth

“Unpasteurized milk,” I repeated.

“Yes. And people who are in contact with animals seem to be at particular risk.”

I put my hand on Katie’s shoulder. “Dr. Zeigler, if I gave you the autopsy report for Katie’s newborn, and then told you that Katie lived on a dairy farm, drank unpasteurized milk daily when she was pregnant, and was actively involved in the milking of the cows twice a day, what would you infer?”

“Based on her living conditions and potential exposure to Listeria monocytogenes, I’d say that she contracted this infection when she was pregnant.”

“Did Baby Fisher exhibit the symptoms of an infant infected with listeriosis?”

“Yes. He was born prematurely and suffered respiratory failure. He showed some signs of granulomatosis infantiseptica, including liver necrosis and pneumonia.”

“Could it have been fatal?”

“Absolutely. Either from the complications of perinatal asphyxia, or simply from the infection.”

“In your opinion, what caused Baby Fisher’s death?” I asked.

“Asphyxia, due to premature delivery, because of chorioamnionitis secondary to listeriosis.” He smiled. “It’s a mouthful, but it basically means that a chain of events led to death by natural causes. The baby was dying from the moment it was born.”

“In your opinion, was Katie Fisher responsible for her baby’s death?”

“Yes, if you want to get technical about it,” Owen said. “After all, it was her body that passed on the Listeria monocytogenes to her fetus. But the infection certainly wasn’t intentional. You can’t blame Ms. Fisher any more than you’d blame a mother who unwittingly passes along the AIDS virus to her unborn child.” He looked at Katie, sitting with her head bowed. “That’s not homicide. It’s just plain sad.”

To my delight, George was clearly rattled. It was exactly what I’d been counting on, actually-no prosecutor was going to dig up listeriosis on his own, and certainly it was nothing George had thought to ask about during the deposition. He stood up, smoothing his tie, and walked toward my witness.

“Listeria,” he said. “Is this a common bacteria?”

“Actually, it’s quite common,” Owen said. “It’s all over the place.”

“Then how come we’re not all dropping like flies?”

“It’s a very common bacteria, but a fairly uncommon disease. It affects one in twenty thousand pregnant women.”

“One in twenty thousand. And it hit the defendant full force, or so you said, because of her tendency to drink unpasteurized milk.”

“That’s my assumption, yes.”

“Do you know for a fact that the defendant drank unpasteurized milk?”

“Well, I didn’t personally ask her, but she does live on a dairy farm.”

George shook his head. “That doesn’t prove anything, Dr. Zeigler. I could live on a chicken farm and be allergic to eggs. Do you know for a fact that every time the defendant reached for a pitcher at the dinner table, it contained milk-rather than orange juice, or water, or Coke?”

“No, I don’t know.”

“Did anyone else in the household suffer the effects of listeriosis?”

“I wasn’t asked to examine paraffin blocks of their tissue,” Owen said. “I couldn’t tell you for sure.”

“Let me help you out then. They didn’t. No one else but the defendant exhibited signs of this mystery illness. Isn’t it strange that a family drinking the same contaminated milk wouldn’t all have the same physical reaction to the bacteria?”

“Not really. Pregnancy is a state of immunosuppression, and listeriosis flares up in immunocompromised patients. If someone in the household had cancer, or HIV infection, or was very old or very young-all of which would compromise the immune system-there might have been another response much like the one Ms. Fisher apparently had.”

“Apparently had,” George repeated. “Are you suggesting, Doctor, that she might not have suffered from this illness?”

“No, she definitely did. The placenta and the infant were infected, and the only way they could have contracted the bacteria is from the mother.”

“Is there any way to prove, conclusively, that the infant was suffering from listeriosis?”

Owen considered this. “We know that he was infected with listeria, because of the immunostaining we did.”

“Can you prove that the infant died from complications due to listeriosis?”

“It’s the listeria that’s fatal,” Owen answered. “It causes the infection in the liver, the lungs, brain, wherever. Depending on the pattern of involvement, the organ that causes death might be different from patient to patient. In the case of Baby Fisher, it was respiratory failure.”

“The baby’s death was due to respiratory failure?”

“Yes,” Owen said. “Respiratory failure, as caused by respiratory infection.”

“But isn’t respiratory infection only one cause of respiratory failure?”

“Yes.”

“Is smothering another cause of respiratory failure?”

“Yes.”

“So isn’t it possible that the baby might have been infected with listeria, might have had evidence of the bacteria in his body and lungs-but his actual death could have been caused by his mother suffocating him?”

Owen frowned. “It’s possible. There would be no way of knowing for sure.”

“Nothing further.”

I was up out of my seat to redirect before George made it back to his table. “Dr. Zeigler, if Katie’s baby hadn’t died of respiratory failure that morning, what would have happened to him?”

“Well, assuming that after the home birth the newborn wasn’t whisked off to a hospital for diagnosis and treatment, the infection would have progressed. He might have died of pneumonia at two or three days of life . . . if not then, he would have died of meningitis within a couple of weeks. Once meningitis develops, the disease is fatal even if it’s diagnosed and treatment is begun.”

“So unless the baby was taken to a neonatal care unit, he most likely would have died shortly after?”

“That’s right.”

“Thank you, Doctor.”

I sat down just as George stood again. “Recross, Your Honor. Dr. Zeigler, you said the mortality rate for listeriosis is high, even with treatment?”

“Yes, nearly fifty out of a hundred babies will die from complications.”

“And you just hypothesized that Baby Fisher would have died within a few weeks, if not that first morning of life?”

“Yes.”

George raised his brows. “How do you know, Dr. Zeigler, that he wasn’t one of the other fifty?”

For reasons I didn’t understand, Katie retreated into her shell with each word of Owen’s testimony. By all accounts, she should have been as pleased as I was. Even George’s little dig at the end of his recross couldn’t take away from the fact this fatal bacteria had been found in the baby’s body. The jury, now, had to have a reasonable doubt-which was all that we needed for an acquittal.

“Katie,” I said, leaning close to her, “are you feeling all right?”

“Please, Ellie. Can we go home now?”

She looked miserable. “Are you sick?”

“Please.”

I glanced at my watch. It was three-thirty; a little early for milking, but Judge Ledbetter would never know that. “Your Honor,” I said, getting to my feet, “if it pleases the court, we’d like to adjourn for the afternoon.”

The judge peered at me over the edge of her glasses. “Ah, yes. The milking.” She glanced at Owen Zeigler, now sitting in the gallery. “Well, if I were you I’d make sure to wash my hands when I was done. Mr. Callahan, do you have any objections to an early dismissal for farm chores?”

“No, Your Honor. My chickens will be thrilled to see me.” He shrugged. “Oh, that’s right. I don’t have chickens.”