Plain Truth

by Jodie Picoult

  “It’s an often unrecognized cause of preterm delivery and perinatal death,” Owen said. “Infection in the second or third trimester usually leads to either stillbirth or preterm birth followed by pneumonia and neonatal sepsis.”

  “Hang on a second,” I said. “You’re saying that Katie contracted some infection that may have compromised the health of her baby before it was even born?”

  “That’s exactly what I’m saying. Moreover, it’s extremely difficult to diagnose in time to initiate therapy. The mother will exhibit flu-like symptoms-fever, aches, mild pain-only hours before the premature delivery takes place.”

  “What is the effect on the newborn?”

  “Perinatal depression, fever, and respiratory distress.” He paused. “The mortality rate for the newborns, in case studies, is somewhere between thirty and fifty percent even after treatment.”

  “An infant infected with listeria has a fifty percent chance of dying even if treated?”

  “Correct.”

  “How do you contract listeriosis?” I asked.

  “From the studies I’ve seen, eating contaminated food is the most frequent mode of transmission. Particularly unpasteurized milk and cheese.”

  “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 accou
nts, 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.”

  The judge frowned at him. “No need to be a cosmopolitan snob, counselor. All right, then. We’ll reconvene tomorrow at ten A.M. Court is adjourned.”

  Suddenly a wall of people surrounded us: Leda, Coop, Jacob, Samuel, and Adam Sinclair. Coop slid his arm around my waist and whispered, “I hope she has your brains.”

  I didn’t answer. I watched Jacob trying to crack jokes that would make Katie smile; Samuel standing tight as a bowstring and careful not to let his shoulder brush against Adam’s. For her part, Katie was attempting to keep up a good front, but her smile stretched across her face like a sheet pulled too tight. Was I the only one who noticed that she was about to fall apart?

  “Katie,” Adam said, stepping forward, “do you want to take a walk?”

  “No, she does not,” Samuel answered.

  Surprised, Adam turned. “I think she can speak for herself.”

  Katie pressed her fingers to her temples. “Thank you, Adam, but I have plans with Ellie.”

  This was news to me, but one look at the desperate plea in her eyes and I found myself nodding. “We need to go over her testimony,” I said, although if I had my way there wasn’t going to be any testimony from her at all. “Leda will drive us back. Coop, can you manage to get everyone else home?”

  We left the way we had on Friday: Leda drove to the rear of the court-house to pick Katie and me up at the food service loading dock. Then we circled to the exit at the front of the building, passing all the reporters who were still waiting for Katie to appear. “Honey,” Leda said a few minutes later. “That doctor you put on the stand was something else.”

  I was looking into the little vanity mirror above the passenger seat, rubbing off circles of mascara beneath my eyes. Behind me, in the backseat, Katie turned to stare out the window. “Owen’s a good guy. And an even better pathologist.”

  “That bacteria stuff . . . was it real?”

  I smiled at her. “He wouldn’t be allowed to make it up. That’s perjury.”

  “Well, I bet you could win the case on that doctor’s testimony alone.”

  I glanced into the mirror again, trying to catch Katie’s eye. “You hear that?” I asked pointedly.

  Her lips tightened; other than that, she gave no indication that she’d been listening. She kept her cheek pressed to the window, her eyes averted.

  Suddenly Katie opened the car door, causing Leda to swerve off the road and come to a screeching stop. “My stars!” she cried. “Katie, honey, you don’t do that when we’re still moving!”

  “I’m sorry. Aunt Leda, is it all right if Ellie and I walk the rest of the way?”

  “But that’s a good three miles!”

  “I could use the fresh air. And Ellie and me, we have to talk.” Katie smiled fleetingly. “We’ll be okay.”

  Leda looked to me for approval. I was wearing my black flats-not heels, granted, but still not my first choice for hiking shoes. Katie was already standing outside the car. “Oh, all right,” I grumbled, tossing my briefcase into the seat. “Can you drop this off in the mailbox?”

  We watched her taillights disappear down the road, and then I turned to her, arms crossed. “What’s this about?”

  Katie started walking. “I just wanted to be alone for a bit.”

  “Well, I’m not leaving-”

  “I meant alone with you.” She stooped to pick a tall, curly fern growing along the side of the road. “It’s too hard, with the rest of them all needing a piece of me.”

  “They care about you.” I watched Katie duck beneath an electric fence to walk through a field milling with heifers. “Hey-we’re trespassing.”

  “This is Old John Lapp’s place. He won’t mind if we take a shortcut.”

  I picked my way through the cow patties, watching the animals twitch their tails and blink sleepily at us as we marched across their turf. Katie bent down to pick tufted white dandelions and dried milkweed pods. “You ought to marry Coop,” she said.

  I burst out laughing. “Is that why you wanted to talk to me alone? Why don’t we worry about you first, and deal with my problems after the trial.”

  “You have to. You just have to.”

  “Katie, whether I’m married or not, I’ll still have the baby.”

  She flinched. “That’s not the point.”

  “What is the point?”

  “Once he’s gone,” she said quietly, “you don’t get him back again.”

  So that was what had her so upset-Adam. We walked in silence for a while, ducking out the other side of the pasture’s electric fence. “You could still make a life with Adam. Your parents aren’t the same people they were six years ago, when Jacob left. Things could be different.”

  “No, they couldn’t.” She hesitated, trying to explain. “Just because you love someone doesn’t mean the Lord has it in His plan for you to be together.” All of a sudden we stopped walking, and I realized two things at once: that Katie had led me to the little Amish cemetery; and that her raw emotions had nothing to do with Adam at all. Her face was turned to the small, chipped headstone of her child, her hands clenching the posts of the picket fence. “People I love,” she whispered, “get taken from me all the time.”

  She started crying in silence, wrapping her arms around her middle. Then she bent forward, keening in a way she had not the whole time I had known her: not when she was charged with murder, not when her infant was buried, not when she was shunned. “I’m sorry,” she sobbed. “I’m so sorry.”

  “Don’t, Katie.” I gently touched her shoulder, and she turned into my arms.

  We stood in the lane, rocking back and forth in this embrace, my hands stroking her spine in comfort. The wild weeds Katie had gathered were strewn around our feet, an offering. “I’m so sorry,” she repeated, choking on the words. “I didn’t mean to do it.”

  My blood froze, my hands stilled on her back. “Didn’t mean to do what?”

  Katie lifted her face. “To kill him.”

  SEVENTEEN

  By the time Katie ran up the driveway, a stitch in her side, the men were doing the milking. She could hear the sounds coming from the barn and she found herself drawn to them. Around the edge of the wide door she could see Levi pushing a wheelbarrow; Samuel stooping to attach the pump to the udders of one of the cows. A suck, a tug, and the thin white fluid began to move through the hose that led to the milk can.

  Katie clapped her hand over her mouth and ran to the side of the barn, where she threw up until there was nothing left in her stomach.

  She could hear Ellie calling out as she limped her way up the drive. Ellie couldn’t run as fast as she could, and Katie had shamelessly used that advantage to escape.

  Slinking along the side of the barn, Katie edged toward the nubby, harvested fields. They were not much use for camouflage now, but they would put distance between her and Ellie. Lifting her skirts, she ran to t
he pond and hid behind the big oak.

  Katie held out her hand, examining her fingers and her wrist. Where was it now, this bacteria? Was there any left in her, or had she passed it all on to her baby?

  She closed her eyes against the image of her newborn son, lying between her legs and crying for all he was worth. Even then, she’d known something was wrong. She hadn’t wanted to say it out loud, but she had seen his whole chest and belly work with the effort to draw in air.

  But she hadn’t been able to do anything about it, just like she hadn’t been able to keep Hannah from going under, or Jacob from being sent away, or Adam from leaving.

  Katie looked at the sky, etched with sharp detail around the naked branches of the oak. And she understood that these tragedies would keep coming until she confessed.

  Ellie had defended guilty clients, even several who had patently lied to her, but somehow she could not recall ever feeling so betrayed. She fumed up the drive, furious at Katie for her deception, at Leda for leaving them three miles away, at her own sorry physical shape that left her breathless after a short jog.

  This is not personal, she reminded herself. This is strictly business.

  She found Katie at the pond. “You want to tell me what you meant back there?” Ellie asked, bending down and breathing hard.

  “You heard me,” Katie said sullenly.

  “Tell me why you killed the baby, Katie.”

  She shook her head. “I don’t want to make excuses anymore. I just want to tell the jury what I told you, so this can be over.”

  “Tell the jury?” Ellie sputtered. “Over my dead body.”

  “No,” Katie said, paling. “You have to let me.”

  “There is no way in hell that I’m going to let you get up on that stand and tell the court you killed your baby.”

  “You were willing to let me testify before!”

  “Amazingly enough, your story was different then. You said you wanted to tell the truth, to tell everyone you didn’t commit murder. It’s one thing for me to put you on as a witness if you don’t contradict everything else my strategy has built up; it’s another thing entirely to put you on so that you can commit legal suicide.”