Yoselyn Ortega cried in court today.
It was the first time I’ve seen her do that. She held still, stone-faced, during hours of testimony about the brutal deaths of Leo and Lucia Krim, the children she stabbed to death in 2012. She laughed during testimony from an NYPD detective. She scoffed when a therapist she saw three days before the crime testified. (He said she hadn’t seemed psychotic.) But Friday, during a break in testimony from a psychiatrist who treated the nanny after the crime, was the only time I have seen Yoselyn Ortega cry.
The moment was brief. The jury was out on a break and Dr. Marc Dubin was still in the witness stand, waiting. The defendant’s face crumpled and tears began to slide down her face. With both hands, she wiped away tears, lifting her eyeglasses. Defense attorney Valerie Van Leer-Greenberg leaned over Ortega, speaking in comforting tones. I heard the phrase “nice man,” but then the jury came back and the moment ended. Van Leer-Greenberg sat down; Ortega composed herself. The trial resumed and the murder defendant returned to staring straight ahead, in silence.
Dr. Marc Dubin is a soft-spoken psychiatrist who treated Ortega at Weill Cornell hospital in the month after the murders of Leo and Lucia Krim. For several hours and at the prompting of the defense, Dubin read from psychiatric reports written while Ortega was recovering from stabbing herself in the neck after she’d killed the children she’d been hired to care for.
Psychiatric treatment is standard during hospital care for a person with a wound like Ortega’s, which seemed like attempted suicide. (Lucia and Leo’s mother Marina Krim says Ortega started stabbing herself in the neck when Krim walked in on the bloody scene.) As Ortega emerged from a delirium caused by the treatment for her stab wound, psychiatrists asked about her mood and if she was experiencing auditory or visual hallucinations. Dubin first met with Ortega on November 4, more than a week after the killings and several days after Ortega’s first statements to the police. (Those contained a number of complaints about her job and Marina Krim, and while no lawyer was present, some of the material made it into the trial.)
Initially, Ortega denied hallucinations and told Weill Cornell psychiatrists she had no history of psychosis — but did mention being treated for depression in 1978. Dubin testified that he nevertheless suspected that Ortega’s depression might have psychotic features, citing paranoia “that her employer had it in for her,” which could potentially be a persecutory delusion. Two weeks later, when Ortega complained about hearing voices — including male and female voices saying, “We’re going to kill a lot of people”— the psychiatric team became confident that she was suffering from major depression with psychotic features. She feared people were entering her room at night. She thought the TV was referring to her. These are classic symptoms of psychosis, so the Weill Cornell team treated her with antidepressant and anti-psychotic medications.
And yet it is also a strange fact of this case that some of those classic symptoms of psychosis were, for Ortega, actually true. In the aftermath of the Krim children’s deaths, TV news reports were talking about the “killer nanny.” People did enter her room at night, including the police officers guarding her. Nevertheless, Dubin was, and remains, confident in the diagnosis.
During cross-examination, Assistant District Attorney Stuart Silberg emphasized that Dubin treated Ortega only after the killings, is not a forensic psychiatrist certified to testify on legal thresholds for insanity, and did not rigorously examine Ortega’s statements for signs of malingering — faking symptoms for personal gain. No, Dubin said, he did not use any formal rating scales or tests to judge whether Ortega was malingering, “but I do have a lot of experience evaluating malingering” in his years as a medical psychiatrist in emergency settings. Silberg pressed: But she could have been malingering, right? Otherwise why would it have taken so long for her to report hallucinating? “Patients are not an open book the first time you meet them,” Dubin replied.
“But you can’t be sure, can you?” Silberg asked. “Nothing is 100 percent in medicine or psychiatry, that’s right,” Dubin conceded.
“So it is possible that, upon waking up and with the state of delirium lessening, that she is now making up symptoms?” Silberg asked, gesturing grandly. “I think that’s highly, highly unlikely,” Dubin replied. “Diagnoses tend not to change abruptly overnight.”
“You’ve heard the phrase it’s not paranoid if it’s true?” Silberg later asked. The defense objected, and Silberg moved on.