Where Did the Choice Begin?

WHERE DID THE CHOICE BEGIN? At 4:53 p.m. on January 24th, 2023, Lindsay Clancy sent her husband, Patrick, a text: “I didn't cook anything. It's been a long day.” At 5:10 p.m., she called ThreeV and placed an order for dinner. Around 5:15 p.m., Patrick left the house to collect the food. Before he left, Lindsay asked him to stop at CVS for medication for Cora. He kissed his children goodbye and told them he would be right back. For the next hour, Patrick would be away from the house. At 5:13 p.m., surveillance footage placed him inside the CVS. At 5:33 p.m., he called Lindsay. She did not answer. One minute later, approximately 5:34 p.m., Lindsay called him back. The call lasted about 14 seconds, and Patrick continued driving. At 5:54 p.m., he was at ThreeV, collecting their dinner. By approximately 6:09 p.m., he was back home. The house was quiet, and by the time Patrick walked through that door, three children had been fatally attacked, and Lindsay was lying injured outside the bedroom window. But that is where the story usually begins. I want to begin somewhere else: not with the discovery not with the fall not even with the first attack. I want to go backward to the hour in which the house was still quiet, the children were still alive, and choices were still being made. Because if we want to understand what happened that afternoon, perhaps the most important question is not simply what happened. It is: where did the choice begin? On January 24th, 2023, Lindsay was home with the kids and husband Patrick. On account of what Patrick testified, she went out to play with the kids in the snow, took one of the kids, Cora, to the pediatrician, and came back home just fine. So it was a normal day. Nothing weird. Little did Patrick know that psychosis doesn't necessarily mean a person won't be able to live or show normal symptoms of life, like laughing, socializing, etc. Let's go back to when she gave birth to her first child, Cora, in 2017. She becomes a mother for the first time (and was indeed said to be a very loving and caring mother by the husband, family members and people around her). A later medical issue would include symptoms of depression and anxiety, but the psychiatric crisis that became central to the case developed years later. After the birth of her second child Dawson, she began experiencing significant anxiety and sought treatment, including a brief period of therapy, and was offered Zoloft around 2019 and early 2020, but she chose not to take it, and the anxiety later resolved. In the year 2022, she went to psychiatrist Doctor Jennifer Tufts and complained about insomnia, and she was given Ativan. But by this time, her anxiety had worsened, so she was prescribed Zoloft. Her treatment with psychiatrist Doctor Jennifer Tufts became a central part of the prosecution and defense examination. Doctor Tufts was one of the important medical witnesses because she treated Lindsay and reported Lindsay as appearing anxious and depressed during virtual appointments. The reports also say that she did not express an intention to harm her children or herself during these appointments. Several different drugs were prescribed during the months leading up to January 2023. About 13 different psychiatric medications were prescribed between October 2022 and January 2023, with more than 30 prescriptions issued during that period. Here are the following medications that we identified in public reports about Lindsay's treatment: Zoloft, Ativan, Benadryl, Buspirone, Trazodone, Prozac, Ambien, Remeron, Klonopin, Seroquel, Valium, Lamictal, and Amitriptyline. These are the 13 drugs. The public reports also refer to additional psychiatric medications, with one account describing at least nine medications prescribed over the relevant period. As the month progressed, public accounts of the case described Lindsay's mental health as deteriorating. The symptoms include severe insomnia, anxiety, depression, increasing psychiatric distress, questions about hallucinations, and psychosis. Some online digital searches made by Lindsay include terms like psychosis, hallucinations, schizophrenia, psychiatry, sociopath. But before we go there, from January 1st to January 5th, 2023, Lindsay was voluntarily admitted to McLean Hospital. They said she was admitted because she was experiencing severe major depressive disorder, which was diagnosed by Doctor Alia Goodheart, without psychotic features, and was released after showing signs of improvement in sleep and mood. However, the records do not show that she was taking all the things simultaneously, as medications were repeatedly started, stopped, changed, or adjusted. By January, her digital searches were increasingly focused on psychiatric symptoms and conditions, including hallucination, psychosis, schizophrenia, and the phrase, “Can you treat a sociopath?” Though such searches do not by themselves directly prove that Lindsay was psychotic, they provide another piece of evidence about what she was researching and possibly trying to understand in the weeks before the killings. These, for me, these are what I would call deliberate actions. In the virtual visit on January 23, 2023, the day before the killings, Dr. Jennifer Tufts said Lindsay appeared to have little motivation, feeling numb, and having to force herself out of the bed and the house. Yet Lindsay denied suicidal and homicidal thoughts, and Dr. Tufts testified that she observed no signs of psychosis or mania. The following day, three kids would be dead. Lindsay claims it was approximately after 4 p.m. She had just finished speaking with Patrick, who had left the house to pick up medication for Cora and food for himself and Lindsay. But before this call, Lindsay was in the kitchen of her Duxbury home on the afternoon of January 24, 2023. She was standing near the refrigerator and was preparing to make chicken nuggets for the children. Soon after the call, Lindsay said she heard a man's voice. She described the voice as an external one, rather than one from her own internal thoughts. According to Saathoff's testimony, the voice repeatedly said to her, “This is your last chance. You have to kill your kids and then kill yourself.” She said the voice was persistent and continued while she carried out the killings. According to the account she gave Saathoff, she then took Dawson downstairs to the basement and strangled him with an exercise band. She subsequently killed Cora and Callan in the same manner. After the kids had been silenced permanently, Lindsay said the voice stopped. She then described taking a knife in the kitchen, going upstairs, slashing her wrist and neck, taking pills (powdered), and jumping from the second-story window in an attempt to kill herself. According to defense expert Dr. Philip Resnick, Lindsay was psychotic on January 24 and experienced a command hallucination. What did Lindsay actually intend? Lindsay reported that she intended to kill herself and that the voice instructed her to kill the kids and then herself. Here is the prosecution's interpretation: Prosecutors argued that Lindsay had become suicidal and decided to take her children with her because she did not trust anyone else to care for them after death. That is suicidal intention leading to the decision to kill children as part of that suicide plan. Here is the defense's interpretation: Suicide plus command hallucination leading to killing kids because an external voice commanded her. Then there's another interpretation by Dr. Kirk Helilbrun intrusive thoughts about killing the children and herself, and that she killed the children because she believed she was protecting them from suffering after her own suicide. Hallucination does not equal intrusive thoughts. Dr. Saathoff testified that Lindsay told him the voice did not tell her exactly how to kill the children, yet she successfully chose the basement, weapon of murder, how to kill first, and how to carry out the killings. Very unusual. He also found it suspicious that the voice stopped immediately after the children had been killed. The Voice and the Choice The existence and nature of the voice became one of the central disputes in the case. Lindsay consistently described a male voice commanding her to kill her children and then herself, but the experts disagreed over what that experience represented. The defense interpreted it as a command hallucination arising from psychosis. A prosecution expert considered an intrusive thought more consistent with the evidence, while another prosecution psychiatrist concluded that Lindsay retained criminal responsibility. Lindsay believed she had no choice. Where did the sequence of choice or the loss of them actually begin? MY CENTRAL THOUGHT If psychosis was severe enough to affect her perception, but she carried out a sequence of deliberate actions over time, what does that tell us about criminal responsibility? All the evidence points out to a realization that I've come to: madness does NOT equal UNAWARENESS. In my defense, Lindsay Clancy knew exactly what she was doing. But perhaps that is where the question becomes more complicated. Because knowing what you are doing and understanding the reality of what you are doing are not necessarily the same thing. A person can be deeply mentally unwell and still make decisions. A person can experience distorted thoughts, hallucinations, or psychosis and still perform actions that require planning, movement, and choice. And that is what makes this case so difficult. Lindsay said she heard a voice. She said the voice commanded her to kill her children and then herself, but stopped after killing the children. The defense argued that she was psychotic and experiencing a command hallucination. But the evidence also shows a sequence of deliberate actions: she was alone with the children, she took them downstairs, she used an exercise band, she killed them one after another, and after the killings, she attempted to kill herself. So the question I am left with is not simply whether Lindsay was mentally ill. The question is whether her mental illness removed her ability to choose. Because if it did not, then where do we draw the line between an illness that influences a person's actions and an illness that takes away their responsibility for those actions? Perhaps the most uncomfortable part of this case is that the answer cannot be found simply by asking whether Lindsay was “mad” or “sane.” The real question is more difficult: Where did the choice begin?

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