Following the Followers

Courthouses are weird places. That’s a given. Especially the outsides of courthouses, where it seems 75% of the population goes for a smoke-break roughly five times a day. Okay, I’m exaggerating. 70%.

I’ve had the unique experience of spending ample amounts of time at the Clackamas County Courthouse, where troubled characters ditch their knives in the bushes, then head in for their hearings. Between the scofflaws, defense attorneys, prosecutors, court staff, security and media types, it makes for terrific spectrum of people watching.

Today, the courtroom of Judge Robert Herndon is filled with people who are presumably here to support the Hickmans. These are men and women I have to think have been here before – witnessing the three other cases in which Followers of Christ Church couples stood trial for crimes involving the care of their children. The women wears dresses or skirts that fall below the knees. At least a few of them wear glasses, which I guess is allowed in their faith.

Neonatology expert Joseph Kaempf is testifying about the death of David Hickman, a baby born two months early. He was born to Dale and Shannon Hickman, members of the Followers of Christ Church, who believe in faith-healing. According to the state medical examiner, David had underdeveloped lungs and a bacterial infection, and only lived nine hours. Instead of intervening with medical help, David’s parents (and other participating in his care) anointed him with oil, and prayed over him. Asked by an investigator about their decision, a detective says Dale Hickman told him it was against his religious convictions to call 9-1-1.

Covering a case like this is eye-opening for me. Testifying for the prosecution, Dr. Joseph Kaempf is explaining how a baby is considered full-term at 37 weeks, with 40 weeks being the average length of a woman’s pregnancy. He says the
death rate of 32-week premature babies born in Portland-area neonatal intensive care units is less than 1%. Meaning, their survival rate is greater than 99%. He’s citing statistics for Providence St. Vincent Medical Center, saying in twelve years, out of 1,071 births of babies born at 31-32 weeks, there hasn’t been a single death from respiratory distress syndrome, or premature lung disease. That’s one of the conditions the State Medical Examiner says caused David Hickman’s death.

Another curious statistic: he says preemies born in a NICU can survive at 23-25 weeks. At 24 weeks, their rate of survival is 40-60%. At 25 weeks, 75%.

He’s addressing too, the controversy over mid-wives, who currently aren’t required to be licensed in Oregon, one the few states in which this leniency exists. At-home births are legal, and don’t required midwives to be licensed, but Dr. Joseph Kaempf says although at-home births with mid-wives can be done safely, it’s not recommended, and absolutely not recommended for a the birth of a preemie.

Worth noting is Dr. Kaempf’s opinion of what caused David’s death, how it differs from the opinion of medical examiner Dr. Clifford Nelson. Nelson concluded that sepsis contributed to the newborn’s death, bacteria in his bloodstream. Dr. Kaempf calls this an “error by the coroner.” He believes strongly that David’s death was caused by his premature lung problems, not sepsis. He says the bacteria found inside of David was located in his air pipe, and that it likely was introduced to his body from the spoon-feeding he underwent after his birth. His birth took place at his grandmother’s home in Oregon City.

Dr. Kaempf points out, a premature baby would never be spoon-fed in a hospital.

On cross-examination, attorneys for the Hickmans focus on how a licensed midwife who serves on the Governor’s board (I don’t know who this is) herself gave birth with the assistance of an unlicensed midwife. Mark Cogan goes on to lay out the mistakes that can happen in child-birth, getting Dr. Kaempt to concede that as a medical professional, he is not infallible.

Cogan also drove home the point, in his line of questioning, that obstetricians as a whole are not infallible, and that they carry some of the highest malpractice insurance rates in the country. In outlining the “shocking rate of infant mortality” in the United States, Cogan says two dozen countries have lower rates of infant deaths.

Cogan: “You have babies that haven’t survived?”
Kaempf: “Unfortunately, yes.”

Additionally, Cogan gets Dr. Kaempf to agree to the idea that especially in hospitals, virulent strains of bacteria exist – adding to Cogan’s argument that these medical environments — and secular medicine overall — isn’t perfect, is susceptible to flaws, and is not danger-free for preemies like David.

Shannon Hickman’s defense attorney, John Neidig, is using Dr. Kaempf’s own published writings against him, noting that some of his peers in the world of pediatrics took issues with his previous stances and disagreed with his findings.

Neidig: “Some of your positions are controversial?”
Kaemf: “Unrelated to this case, yes….”
Neidig: “It had to do with premature children, though.”
Kaemf: “Yes.”

By the way, the current jury has 16 people present. It’s a 12-person jury, but the court lines up four alternates, given the anticipated length of the trial (5 weeks) and the possibility of individuals jurors having to depart the case due to personal reasons. So, all 16 people listen in on testimony. Of the 16, eleven are women. It’s just as curious to watch their expressions, their reactions, to the things that are said in court. Do you think gender of the jury members matter?

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