A psychiatrist testified that Lindsay Clancy appeared “calm and cooperative” during medical evaluations just days after she killed her three children and attempted to take her own life — testimony that prosecutors could use to challenge the defense’s claim that she was experiencing severe postpartum psychosis.
Dr. Sejal Shah told jurors that she examined Clancy multiple times at Brigham and Women’s Hospital in Boston in January and February 2023, shortly after the January 24 killings.
During one assessment on Jan. 30, Shah said Clancy denied having suicidal or homicidal thoughts. She also denied experiencing hallucinations or delusions at the time.
Her thought process, Shah testified, appeared “organized” and “goal-directed.”
The testimony is significant because the central issue in Clancy’s murder trial is not whether she killed her children. The defense has acknowledged that she did.
Instead, jurors must determine whether Clancy was criminally responsible for the deaths or whether postpartum psychosis had impaired her ability to understand what she was doing.
Clancy has pleaded not guilty to three counts of murder in connection with the deaths of her children: 5-year-old Cora, 3-year-old Dawson and 8-month-old Callan.
Prosecutors have argued that Clancy deliberately and methodically killed the children before attempting suicide. They maintain that although she had serious mental health struggles, she remained capable of understanding the difference between right and wrong.
The defense has presented a very different picture, arguing that Clancy was experiencing postpartum psychosis and had lost control of her thoughts and actions.
Shah’s testimony Monday offered prosecutors an important piece of evidence concerning Clancy’s condition after the killings.
During another evaluation in February, Shah said Clancy was focused on her legal and physical circumstances and was looking ahead to rehabilitation.
She was also able to explain why she wanted to change her health care proxy from her husband to her parents.
According to Shah, Clancy explained that she believed her parents were supportive and would act in her best interests.
The defense challenged the significance of these observations during cross-examination.
Shah agreed that Clancy was an “honest” patient, but she also acknowledged that a person can communicate coherently, make plans and interact with others while still experiencing psychosis.
That admission could be important for the defense as it argues that Clancy’s apparently organized behavior after the killings does not necessarily prove she was mentally competent at the exact moment she killed her children.
Another forensic psychiatrist also described Clancy’s condition shortly after the killings.
Dr. Jhilam Biswas testified that she met with Clancy on Jan. 26, two days after the deaths.
At that point, Clancy was still on a ventilator and unable to speak, so Biswas gave her paper and a pen and asked her questions.
Clancy reportedly wrote several questions and statements, including “is my body broken” and “are my legs straight.”
She also asked whether she could have visitors, where her family was and requested an attorney.
Biswas said Clancy appeared anxious but understood what was being asked of her. She did not appear to be experiencing hallucinations or other obvious signs of psychosis during their brief interaction, which lasted approximately 20 to 30 minutes.
One of the most striking things Clancy reportedly wrote was that she was “horrified.”
That statement is likely to be closely examined by both sides because it could be interpreted in different ways.
For prosecutors, it could suggest that Clancy understood the seriousness of what had happened. For the defense, however, it does not necessarily establish what her mental state was at the precise moment she killed her children.
The jury has also heard evidence about Clancy’s struggles before the killings.
Massachusetts State Police Detective John Santos testified that investigators found books and notebooks concerning postpartum depression, anxiety and intrusive thoughts inside the family’s home.
Among the materials was a postpartum anxiety workbook, a notebook containing medication information and the book Good Moms Have Scary Thoughts, which discusses disturbing intrusive thoughts experienced by some mothers.
Clancy’s own writings have also become an important part of the prosecution and defense presentations.
In one diary entry, she wrote that she felt desperate for a mental break from caring for everyone and believed her mind was trying to make something physically wrong with her.
In another entry, she described feeling guilty and struggling with sleep training her infant son Callan.
She also wrote a simple but revealing plea:
“I want help. I want to be well.”
Those writings provide a window into the psychological difficulties Clancy was experiencing in the weeks and months leading up to the killings.
Her husband, Patrick Clancy, previously testified that Lindsay had been struggling with insomnia, anxiety and depression and had been prescribed numerous medications.
He also told jurors that after the killings, Lindsay eventually told him that she had heard a man’s voice telling her that if she did not act immediately, she would lose her opportunity.
That alleged voice has become a major point of disagreement between the prosecution and defense.
The defense argues that the voice was a command hallucination associated with postpartum psychosis and that Clancy believed she had no choice but to follow it.
Prosecutors, however, have questioned whether the alleged hallucination was genuine and whether Clancy’s behavior before and after the killings was consistent with someone who had completely lost touch with reality.
Medical testimony has also given jurors a detailed account of what happened to the children.
Dr. Michael Snyder testified about Cora, describing bruising around her neck and broken blood vessels around her eyes consistent with oxygen deprivation. She had no heartbeat and was not breathing when she arrived at the hospital, and efforts to revive her were unsuccessful.
Doctors who treated Callan described similarly devastating injuries.
The 8-month-old was cold, limp and had marks and swelling around his neck when he arrived at the hospital. He suffered severe brain damage caused by a lack of oxygen and blood.
Although doctors initially placed him on a ventilator and continued treatment, Dr. David Casavant later testified that Callan was brain dead. Life support was eventually withdrawn with his father’s input, and Callan was pronounced dead on Jan. 27.
Clancy herself survived the suicide attempt.
After killing the children, she cut her wrists and neck before jumping from a second-story window. The fall left her partially paralyzed and caused a serious spinal injury.
Doctors testified that she was later transferred to Brigham and Women’s Hospital, where she suffered cardiac arrest and required CPR and multiple blood transfusions.
An ICU nurse recalled that Clancy appeared “flat” during her hospital stay and showed little visible emotion.
Police officers remained outside her hospital room around the clock.
Taken together, the testimony presents jurors with two competing interpretations of the same woman.
The prosecution points to Clancy’s organized thinking, her ability to communicate and plan, her behavior before and after the killings and the absence of obvious hallucinations during early hospital evaluations.
The defense points to her documented mental health struggles, medication history, intrusive thoughts, reported voices and the possibility that postpartum psychosis can exist even when a person appears capable of communicating normally.
That distinction could ultimately determine the outcome of the case.
The trial is expected to continue with more testimony concerning Clancy’s mental state, the events leading up to the killings and what she understood at the time.
At its core, the case remains a battle over one crucial question: Was Lindsay Clancy aware that killing her children was wrong when she did it, or had a severe psychiatric episode taken away her ability to understand the consequences of her actions?
The answer will determine whether the jury views the January 2023 killings as the actions of a woman who deliberately carried out a horrific plan — or the tragic result of a profound psychiatric breakdown.
