When Jarayha Wolf first saw the detectives down the hall from the hospital room where her three-month-old son was on life support, it never crossed her mind that they were waiting for her.
During baby Cameron’s short life, Jarayha worried that something was wrong with him. In utero, he was the smaller and weaker twin, and doctors warned that he might not make it. “The next time you come for a sonogram,” one doctor told her early in the pregnancy, “there might be only one baby in the picture.”
Delivered by emergency C-section at 3-pounds, 9-ounces, Cameron remained in the NIC-U for 17 days. At home, Cameron’s twin sister Chloe’s cry was hardy, while Cameron sounded more like a mouse, squeaky and barely audible. From time to time, his limbs would stiffen strangely and he seemed constantly congested. Then there were those moments when Cameron appeared to stop breathing. Jarayha would blow in his face, he’d gasp, and seem to come back from some faraway place.
After an episode of projectile vomiting, Jarayha visited an Ear, Nose, and Throat doctor, who diagnosed acid reflux, while noting the need for further monitoring, including for the troubling symptom of blue lips. After an 8-week maternity leave, Jarayha returned to The Children’s Hospital at Montefiore, where she’d worked since high school as a business associate, and began asking doctors there for advice. Next she saw a gastroenterologist, who increased the dosage of Cameron’s acid reflux medication.
“You want to think doctors know better,” Jarayha said. “You’re just a mom. You haven’t done years of training.’” Still, Jarayha’s doubts remained.
In September, she approached a neurologist at the hospital. The doctor said she’d had several cancellations that day, and might be able to squeeze Cameron in. Jarayha went home to get him. But then the doctor’s 5 o’clock showed. Her next available appointment wasn’t until January.
On October 3, 2012, Cameron’s father, Jonathan McCleod, called Jarayha at work. “Cameron’s making funny sounds,” he said. He thought maybe his stomach hurt. But when Jarayha came home to see what was wrong, Cameron was wheezing and his stare was blank.
First she called her pediatrician. “He sounds like he’s sighing,” the receptionist told her. “No,” said Jarayha, “he sounds like a siren.” Then Jarayha called her sister. Next she called her mother, a nurse, who came right over. She told Jarayha not to wait. So Jarayha wrapped Cameron in a blanket and rushed one block from their home to the emergency room.
“No Mom, he’s okay,” the nurse who took Cameron reassured her. “He’s breathing. His chest is moving.” But when Jarayha walked back into Cameron’s room after registering, there were at least a dozen doctors surrounding Cameron’s tiny body, feverishly removing his clothes. Jarayha struggled to take it in.
Soon, Jonathan arrived. He’d been Jarayha’s first boyfriend, starting in 8th grade, and though their romantic relationship had been on and off over the years, they were each other’s best friends. Other relatives came, too. Jarayha, 24, grew up in the Bronx on Gun Hill Road, in the same neighborhood as the hospital, surrounded by a large family who’d moved en masse from the South several generations before. Jarayha was used to knowing that if there were trouble, someone would step up. Now, too, her family showed up in full force.
The doctors told them that Cameron was suffering from meningitis and pneumonia and that they would be treating him aggressively with antibiotics. After they hooked Cameron up to a ventilator, Jarayha saw Cameron look at her, close his eyes, then look at her again. She allowed herself to hope.
Next, the hospital intubated Cameron. When they opened the curtains around his bed, wires were hanging everywhere and Cameron was again unresponsive. Still, like a broken record, the nurse repeated: “He’s okay, Mom. He’s doing good.” But soon after, told her that Cameron wasn’t responding to the medication. It was unlikely he would last the night. Then 24 hours passed.
“In my head I thought, ‘He’s still here. It’s 24 hours. He’s going to be OK,’” Jarayha recalled. But early on October 5, a doctor approached again. Cameron was likely brain dead.
By then, some of the doctors at Montefiore Children’s Hospital had begun to think that someone had done something terrible to Cameron—and the most likely suspects were Jarayha and Jonathan.
That’s because Cameron was suffering from the classic triad of bleeding behind the eyes, bleeding around the brain, and brain swelling, used to diagnosis Abusive Head Trauma (AHT), formerly known as Shaken Baby Syndrome. Neither Jarayha nor Jonathan could explain why; what they quickly learned is that when it comes to child abuse, lack of an explanation is quickly equated with guilt.
For decades, doctors were trained that short of falling from an upper-story window or the impact of a major car crash, the triad of symptoms was likely caused one way only: abuse in the form of violent shaking.
But over the past decade, both the science behind Shaken Baby Syndrome and the process by which doctors make the diagnosis have been challenged. Between 2001 and 2015, with the help of Innocence Projects around the country, 16 criminal convictions in the United States based on Shaken Baby Syndrome were overturned and prisoners freed, sometimes after a decade or more behind bars. More than 200 cases ended when charges were dropped or dismissed, defendants were found not guilty, or convictions were overturned, according to a study by The Washington Post and Northwestern University’s Medill Justice Project.
But as doubts about the diagnosis have mounted, doctors in the tradition of those who, in the 1970s, lead the movement that created the child welfare system we have today, have fought back. They argue that those who question the diagnosis undermine decades of work done to protect abused children.
Increasingly, the debate has become polarized and bitter. In an interview with The Daily Beast, Dr. Robert Block, former president of the American Academy of Pediatrics and current chairperson of the international advisory committee for the National Center on Shaken Baby Syndrome, argued that it is only a small group of doctors who have “used chicanery”—questionable research and far-fetched explanations—to create “an illusion of widespread doubt about the diagnosis.” While the AAP changed the name from Shaken Baby Syndrome to Abusive Head Trauma in a move away from a single-minded focus on shaking to include banging, dropping, and throwing, the organization has largely dismissed the debate, stating that the only real controversy exists in the courtroom and in the media.
The AAP does acknowledge that the symptoms of accidents, diseases, and genetic defects can mimic abuse, and even that innocent parents may be regularly accused of abusing their children. A report on multiple bone fractures by the AAP’s 2005-2006 Committee on Child Abuse and Neglect stated that while “child abuse is the most frequent cause” of such fractures, “many parents of children with genetic or metabolic bone disease report that they were initially accused of abusing their children.” They note, as well, that parents’ inability to explain a child’s symptoms is often taken as proof of guilt, despite the fact that “[f]amily members of a child having an undiagnosed bone disorder…may be completely bewildered by the injuries.”
When it comes to Abusive Head Trauma, however, defenders of the diagnosis argue that doctors should not look so hard for the needle in the haystack that they ignore the haystack of abuse, or the children harmed by it. “If the potential for a positive test result [for a blood disorder] is microscopically small…there is very little value in sending for a test,” a 2013 article in the Houston Journal of Health Law and Policy by leading pro-AHT doctors states. They point to a large body of clinical studies that suggest that alternative causes of the symptoms are exceedingly rare to support their position.
But their critics say that the mountain of clinical evidence they cite is a house of cards, based on studies done in hospitals that, for decades, simply assumed the triad of symptoms equaled abuse. Once upon a time, they say, doctors diagnosed abuse whenever they saw the triad of symptoms, and now doctors use those same potentially faulty diagnoses to prove that their approach to diagnosing abuse is correct. The presumption of abuse, they add, causes some doctors to overlook alternative explanations for a child’s symptoms, even when those symptoms are staring them in the face.
“In the end [doctors] say, ‘You have to trust our clinical judgments,’” said Keith Findley, director of the Wisconsin Innocence Project and former president of the Innocence Network. “But what informs their clinical judgments? If every time they see the constellation of symptoms they say it’s abuse, well, there’s no treatment for abuse, so they never get feedback that they’re wrong.”
In this partisan atmosphere, charges of abuse continue to be brought and aggressively prosecuted far more in some locales than others, suggesting that determinations of abuse depend on the culture of the hospital, the local prosecutors’ office, and the child welfare agency. New York is among a handful of states that has seen the largest number of such cases brought to trial, according to the Medill Justice Project. Critics add that the power of accusing doctors has only grown in recent years, since the graduation in 2009 of the first group of board-certified child abuse pediatricians.
The specialty was created to address concerns that many doctors are neither experienced nor comfortable diagnosing abuse. Indeed, a 2011 study found that 27 percent of doctors who believe a child’s injury was “likely” or “very likely” the result of abuse did not report it, because of uncertainty about the diagnosis, lack of faith in child protective services, fear the child would be removed, or because they did not want to involve themselves in a legal process.
But the specialty was also created at a time when the fight about Shaken Baby Syndrome/Abusive Head Trauma was heating up. Diane Redleaf, executive director of the Family Defense Center in Chicago, says that child abuse pediatricians and their supporters have waged a campaign in the medical literature suggesting that they have greater skill in diagnosing abuse even than doctors that have specialized training in the symptoms a child is showing, often effectively silencing dissent.
Even when doctors do weigh in to the contrary, she says, the child abuse pediatrician’s title and ongoing relationship with child welfare and court personnel often means they are the ones that judges, lawyers, and child welfare officials trust, while in some locales, child abuse investigators are explicitly trained to defer to their opinions.
It was a child abuse pediatrician at Monterfiore Children’s Hospital, Penny Grant, who first came to question Jarayha. Grant was also on the board of the New York Society for the Prevention of Cruelty to Children, and as such, co-hosted celebrity-studded events to raise money to address child abuse. Combatting abuse was both her professional and her philanthropic mission.
When Grant first approached Jarayha, Jarayha recalls, she asked her simply to tell her what happened. “Did someone hurt Cameron?” “No,” Jarayha answered. “Did he fall?” “No.” “Did someone shake him?” “No.”
Jarayha said that at first, she had no idea that Grant was questioning her for anything other than medical purposes, or that her answers were going to be shared with police and child protection. It never occurred to her to ask for a lawyer.
Grant asked her to describe what had happened the day before Cameron entered the hospital. Jarayha said she’d taken the twins shopping for their Christmas outfits. Cameron had seemed fussy, but Jarayha thought it was just typical baby fussiness. “I thought, he’s a boy, he doesn’t like shopping,” Jarayha later recalled.
Next, though, hospital officials asked Jarayha to speak with a lawyer from New York City’s Administration for Children’s Services (ACS). Jarayha had previously seen two uniformed men down the hall from Cameron’ room but thought little of them. Now she approached the officers. “‘My name is Jarayha Wolf,” she told them. “Are you here for me?” They told her it would be better to talk down at the station. Neither Jarayha nor Jonathan had eaten or slept in 24 hours.
Before she left, Jarayha signed papers giving her sister authority to make medical decisions for Cameron in her absence. “Anything you have to do, just make sure he’s still alive,” Jarayha told her sister.
The detectives said the questioning would only take an hour. But down at the precinct they and the ACS lawyer questioned Jarayha and Jonathan in separate rooms for several hours. Most of all, they wanted to know if Jarayha thought Jonathan had done it.
Soon Jarayha saw police walk into the precinct with the baby chair that Cameron slept in and his baby blanket. “I was crying,” Jarayha recalled. “My body was numb.” Finally Jarayha asked detectives: “Am I getting arrested?” “No,” they said, and Jarayha left.
But back at the hospital, a nurse approached Jarayha. “The father shook him. He did. He’s not allowed to stay the night,” Jarayha recalls her saying. Jarayha knew hospital protocol, and she confronted the nurse manager, who said Jonathan was allowed to stay. But Jarayha was beginning to get a taste of what it was like to have people around her who were sure that someone was guilty.
A comment from Montefiore’s public relations office said: “We share in the family’s deep sense of loss and out of respect for the privacy of all of our patients, cannot share information about individual cases.” The hospital declined to comment about the broader issues surrounding the case.
Cameron remained on life support for several days.
During that time, much of Jarayha’s large extended family and members of Jonathan’s family crowded into the hospital—grandparents, sisters, cousins, aunts, uncles, more than 50 relatives. They spilled into the hallways and took over the family lounge. Cameron’s room was dark but a sea of people surrounded him.
Then, on October 7, hospital personnel told Jarayha and Jonathan that they could hold Cameron one last time. “She put him in my arms,” recalls Jarayha. “He looked so small, but he was heavy. His head felt so heavy…I just held him. I didn’t know what to do. I didn’t know how to say goodbye.”
Neither Jarayha nor Jonathan was ever arrested. But the standard for removing a child from her family when abuse is suspected may be lower than that required to make an arrest, because a child’s safety is assumed to be at stake. Following Cameron’s death, Cameron’s twin sister Chloe was removed from Jarayha and Jonathan’s custody and placed with Jarayha’s aunt, Brenda McDuffie, with whom Jarayha’s mother lived. Jarayha and Jonathan were indicated as child abusers by child protective services.
A few days later, Jarayha and Jonathan had their first date in family court. There the judge determined that Chloe would remain with McDuffie and Jarayha’s mother, while Jarayha and Jonathan would be allowed to visit Chloe for just one hour three times a week, at a child welfare agency visiting room.
At the time, Jarayha and Jonathan knew little about the overburdened family court system, where judge’s dockets are so full that it is common for hearings to be scheduled months apart. “I thought it would be like on TV, where a trial lasts two days,” Jarayha said. Nor did they know that it in complicated medical cases like theirs, it would take their lawyers a full year of discovery to even be ready to start the trial. All they felt was shock at the casualness with which their family was being destroyed.
The next few months were the hardest.
“My mind was clouded. There were days when I didn’t know what would be next,” Jarayha recalls. “With one child, I had gone from picking out a stroller to picking out a casket. My daughter was with family and I knew she would never go to foster care. Still, how do you accept that you’re not able to see your own child?”
Jarayha’s hair began to thin. She had migraines. Some days she didn’t eat. Most nights she couldn’t sleep. Instead, she would channel surf until 3 or 4 in the morning, when exhaustion finally overcame her. She felt, she said, that a piece of her life was missing, and she couldn’t rest until it was returned. “My body just got numb and pain became a normal part of my routine.”
The court mandated that Jarayha and Jonathan go to grief counseling at their church, but like many parents mandated to heal with the threat of losing their child forever hanging over their heads, Jarayha and Jonathan just went through the motions.
As a child, Jarayha had been outspoken, she said, and even as an adult, if she didn’t like something, she’d tell you. “But in court,” she explained, “they say things to make you upset, to make you blow up. They think, ‘This is the monster you are.’” Jarayha knew she couldn’t afford to lose control and prove them right. When the future of her family depended on her not giving in to her emotions, she wondered, how could they also mandate her to grieve?
Instead, she found other ways to cope.
Jarayha had been raised in the Baptist Church and her brother-in-law was an ordained minister. He counseled her not to question God’s plan, and a certain stoicism and faith that goodness would prevail, Jarayha found, helped more than counseling. “I told myself, ‘The Devil’s a liar and my truth will come out.’”
If they were going to get through this, Jarayha and Jonathan decided, they needed to do it as a team. It helped, Jarayha said, that their families had known each other for years. Together they visited Chloe in the agency’s bright yellow visiting room, rushing there after work—for Jonathan from his job as a security guard at Best Buy, for Jarayha from a new position at a new Montefiore location—so as to not be late before the offices closed at 6:30. The caseworker was always there in the room, standard protocol for visits when child welfare determines that it’s not safe for parents to be alone with their children.
“We would feed her, hold her, kiss her,” said Jarayha, and try to make normal family memories. It was in that room that they brought Chloe her first snowsuit. It was there that they spoon-fed Chloe for the first time. As soon as Chloe tasted the carrot puree, her lips went rubber and orange sprayed the room. Jarayha and Jonathan laughed and tried again.
Then the hour would be over.
Over time, workers saw how well Jarayha and Jonathan interacted with Chloe, and after four months, they were granted visits at Jarayha’s aunt and mother’s house, with the stipulation that they were never to be alone with Chloe.
This gave Jarayha and Jonathan more time to spend with their daughter. When they got off work at the same time, they’d go see her together. When Jonathan had to work late, they’d go separately. They’d bath her, play with her, watch cartoons, feed her dinner, and put her to bed, before returning to their own home. “If she cried, I could console her without someone looking at me to see how I handled her,” Jarayha recalls.
The increased visiting time also gave Jarayha and Jonathan reason to hope that they and their daughter might soon be reunified.
Six months after Cameron’s death, however, the medical examiner’s report came out ruling it a homicide.
That day, Jarayha’s stoicism failed her.
First, she went to Cameron’s grave, sat on the ground for over an hour and cried. She said, “I love you Cameron, but nobody is listening.’” Then she went home, crawled into bed and cried more. In the morning, she tried to get up. Then she lay back down and stayed there all day. Much of the time, she said, she spoke to Cameron, asking him to come to her in her dreams to tell her what happened. In the evening, she got out of bed.
But a few days later, on April 12, 2013, The Daily News published a story about the case. The headline read: “Bronx Baby’s Death Now Considered a Homicide.” The article, citing unnamed police sources, stated that Cameron’s “father, who has not been identified, admitted to grabbing and shaking the child.”
Still, a few months after the medical examiner’s findings, Jarayha and Jonathan were granted two hours of unsupervised visits with Chloe a week. The hours increased as the months before the trial dragged on. During this time, ACS recommended no services for Jarayha and Jonathan other than grief counseling. No anger management. No mental health services. No parenting classes.
In a statement, ACS noted that: “Service planning for parents involved in court proceedings is difficult when the cause of injuries is still undetermined.” Still, it seemed strange to accuse parents of killing a child, and then the only requirement is therapy to deal with their grief. Why would they allow Jarayha and Jonathan more time with their daughter without making efforts at reforming them if they believed one of them really was the killer, her lawyers wondered. But then why would they continue to move forward with their case if they didn’t?
“Jarayha and Jonathan were charged with the unthinkable, yet every caseworker who supervised their interactions with their daughter observed them to be loving, attentive, and responsible parents,” said Emma Ketteringham, managing director of The Family Defense Practice at The Bronx Defenders, and co-counsel assigned to represent Jarayha on the case. “ACS did not offer services to reunify the family because there were none to offer. Jarayha and Jonathan exhibited no signs of mental illness, drug dependence, criminal history, or problems with anger.
“Not only were their interactions with their daughter overwhelmingly positive, both Jarayha and Jonathan were known as being exceptionally patient and good with all children. Jarayha was the chosen caretaker for a disabled cousin and Jonathan was the uncle who spent hours playing with the children at family parties. The charges ACS was pursuing did not match what we all came to know about this family.”
In November 2013, presiding judge Karen Lupuloff granted Jarayha and Jonathan six hours per week of unsupervised visits, visitation on Christmas Eve, Christmas Day, New Year’s Eve, and New Year’s Day, and overnight visits supervised at Jarayha’s aunt and mother’s home. That same month, the trial began. It included 17 days of trial and 52 hours of testimony that stretched over a year and a half, while the city continued to try to prove that either Jarayha or Jonathan had killed Cameron.
In some ways, Jarayha and Jonathan were lucky.
Jarayha was lucky to be appointed an attorney from The Bronx Defenders, one of three institutional legal providers in New York City created over the last two decades to improve legal representation of parents with child welfare cases. Jonathan’s lawyer was a court-appointed solo practitioner and both Jarayha and Jonathan thought he represented Jonathan well.
But family court lawyers around the country are usually paid a flat rate per case and are often not paid well. As a result, they frequently feel the need to take on so many clients that they’re left with little time to meet with their clients outside of court or to develop a strategy robust enough to allow parents a fair chance to fight the power of the state if they choose to do so. In some cases, parents may be left largely on their own to try to find their own medical experts who can tell them what else might have happened to their child and are willing to testify to it in court. Support groups for falsely accused parents on social media provide information to parents in similar situations. But less educated parents, who may lack research skills as well as access to the Internet, may be completely at a loss how to proceed.
Moreover, while in 1985, the Supreme Court ruled that defendants’ due process rights are violated when the court does not provide them with funds for expert testimony in cases that require it—and courts typically do make such funds available—the ruling did not make clear which cases those were, leaving it up to the individual court’s discretion, said Findley of the Wisconsin Innocence Project. In a number of abusive head trauma cases around the country that have since been overturned, Findley said, the defense in the original case was either unable to put on any expert witnesses for lack of funding, or failed to do so.
At other times, he adds, while funding is there, it may not be enough to provide the kind of extensive testimony a parent might need to overcome the persuasive power of the child abuse pediatrician or the other doctors testifying against them. “Typically the prosecution can call in a long list of experts to testify on their behalf, while the typical criminal defendant or a parent in family court facing removal of their children doesn’t have the resources to do that,” added Findley.
Without those resources, even the most well-intentioned family court lawyers can feel that the best advice they have to offer their clients is to submit to the findings of the court that they have in fact done something terrible to their child, in the hopes of convincing the judge that they have “insight” into their wrongdoing and can be reformed and reunified.
When Jarayha was assigned a lawyer, by contrast, that lawyer came with an institution behind her, with a veteran supervisor with years in the field and a reputation for fighting hard for parents to serve as her co-counsel, plus social workers, parent advocates, and investigators to gather and file paperwork, to attend meetings with the city between court dates to push for increased visitation, and to be in contact with Jarayha when her lawyers couldn’t. The Bronx Defenders lawyers also came to the work with a social justice mission and an ideology that believes that while children need to be protected, so too, do poor families and families of color.
Jarayha’s extensive efforts on Cameron’s behalf before his death also helped The Bronx Defenders enlist the pro bono services of Paul, Weiss, Rifkind, Wharton & Garrison, a major corporate law firm.
Paul, Weiss calculates that between 2013 and 2015, their lawyers spent 3,750 hours working alongside The Bronx Defenders on this case, including late nights and weekends. It was common for Paul, Weiss attorneys Audra Soloway and Heather Navo to communicate with each other about the case before they went to bed at night and when they woke up in the morning.
During the nearly three years that the case was ongoing, Jessica Horan-Block, co-counsel on the case for The Bronx Defenders with supervisor Emma Ketteringham, married and had a baby of her own. But the case had become such a central part of her existence, she said, that during the 14 weeks that she was on maternity leave, it was hard for her to be away from it.
In turn, those attorneys were able to enlist a handful of medical specialists to look closely into what might have happened to Cameron in the days before his death, to develop a theory of the case, and to testify to that theory in court multiple times over multiple days.
When Peter Cummings first received the medical records, they seemed incomplete to him. Cummings had worked for Boston's medical examiner before he left to start his own consulting practice. Cummings decided he needed to come to New York and take a look at Cameron’s brain and body for himself.
In New York City, to his surprise, the first thing Cummings saw when he picked up Cameron’s brain from the bucket was that no one had ever opened the sinuses in the brain to look for clotting. Cummings would later testify in court that he could see no cuts that had been made in the dural sinuses. When he did, what he saw surprised him. In her report, the medical examiner, Margaret Prial, had said that Cameron’s veins were “patent,” meaning open. But Cummings could see blood clots with his bare eyes.
For Daniel Sahlein, the presence of clots through Cameron’s brain was a critical finding. At the time of the case, he was an assistant professor of radiology at Columbia University Medical Center, and had the unusual credentials of having completed residencies in both radiology and neurology. From the MRI, Sahlein told Jarayha’s lawyers, he, too, saw clearly that there were clots throughout Cameron’s brain, and he believed those extensive brain clots—or cerebral venous sinus thrombosis—were likely what killed Cameron.
Blood by its nature tries to find an outlet, and when there’s a blockage, babies’ brains are particularly good at finding detours around those blocks into unblocked veins. Looking at the extensive clotting, it seemed likely to Sahlein that those moments when Cameron’s limbs stiffened, when he appeared to stop breathing, and so many other symptoms that Jarayha had found troubling in the first three months of Cameron’s life, were symptoms of a blockage. And then Cameron’s brain found detours around them, and the symptoms cleared.
Until Cameron’s brain could no longer find any detours, and then he died.
What the MRI didn’t tell Sahlein was what had caused the clots. But what he had little doubt had not caused them was shaking. Indeed, in a series of 12 studies including some 700 pediatric patients with brain clotting, he later testified in court, not one case had been caused by shaking. As a radiologist, Sahlein could also tell from Cameron’s MRI that some of his clots had formed before the alleged shaking happened. This, he believed, was further evidence that Cameron’s symptoms had not been caused by shaking.
For privacy reasons, the NYC Office of Chief Medical Examiner could not comment on the specifics of the case. In a statement to The Daily Beast, however, Julie Bolcer, its director of public affairs, refuted the idea that an initial finding of abuse in the case might have unduly influenced the medical examiner. Instead, she noted that homicide is always considered in the death of a child, but that “to rule on the cause and manner of death, the medical examiner performs a complete, independent investigation.”
But Cummings saw other findings in the medical examiner’s report that suggested otherwise. While the Montefiore doctors had noted that Cameron was suffering from hazy opacity—a sign of infection—according to Cummings the medical examiner’s report stated that there was no infection present in Cameron’s body. When Cummings looked, he saw that Cameron had a rash on his chest, an elevated white blood count, and protein in his urine. When he looked at Cameron’s kidneys under the microscope, he saw inflammation and scarring. When he looked at the brain, he saw damage to the blood vessel walls and dark, angry-looking cells. Cummings said these were clear signs that Cameron had had a virus.
Cummings thought it was likely that in trying to fight the virus, Cameron’s immune system had begun to attack his own body, causing the inflammation in his brain’s blood vessels, and that this inflammation had caused the clots. He believed it was also likely that Cameron had had some underlying medical condition that led him to be more susceptible to a bad outcome of the viral infection in the first place.
Cummings acknowledged that these were just theories. Not knowing precisely, Cummings said, is a common frustration in pediatric autopsies, because children are not miniature adults, and understanding their bodies tends to be even more complicated than understanding adults’. Despite that, Cummings said, when he looked at the facts before him, he saw no evidence of abuse, while so very many signs—from the clots in the brain to the infection throughout the body to the problems experienced before and after birth—argued that Cameron had died from natural causes.
Was it possible that Cameron was suffering from a virus, old blood clots, and trauma, I asked. After all, research has found that sick children are at an elevated risk for abuse because they can be hard to care for. “Anything is possible,” said Cummings. “It’s possible that Amelia Earhart, Elvis, and Big Foot are waiting outside to have a beer with me. But it’s not bloody likely. There’s a big difference between what’s possible and what’s likely.” In science, Cummings said, you have to look at the evidence, and in this case, when he looked for abuse: “There was no evidence of that.”
Lastly, Jarayha’s lawyers brought in Khaled Tawansy, director of The Children’s Retina Institute in California. Tawansy explained that the retinal hemorrhages in Cameron’s eyes followed the path of the blood vessels, while with a shaking injury, the hemorrhages would be more scattered. He found that Cameron’s eyes also lacked the retinal tearing typically associated with shaking. Tawansy found other features, including the detachment of Cameron’s retinas and the death of the retina tissue cells, which he said were more indicative of disease than of a trauma.
Lastly, by looking at the hospital doctors’ notes, Tawansy said he saw that the hemorrhaging had worsened during the time that Cameron was in the hospital. If shaking had caused the hemorrhages, he said, Cameron’s eyes would not have continued to deteriorate.
In October 2013, Jarayha’s doctors and lawyers decided that they had overwhelming evidence that Cameron had not been abused. In hopes of bringing Chloe home faster and bringing an end to the case, they offered to share their findings with the doctors at the NYC Medical Examiner’s Office.
In a statement, Bolcer stated that: “I am not able to comment on specific instances, but in general, our office receives requests to meet with representatives from defense and routinely does so.” In this instance, Jarayha’s lawyers and doctors say, the office refused. And so, on November 13, 2013, the trial commenced.
Sometimes in court, Jarayha would listen attentively, especially when the doctors testifying on her behalf explained what they believed had ultimately killed Cameron. Other times, the testimony would be too upsetting.
At those times, overcome with nausea, Jarayha would look down. She would take her lawyers’ pad of paper and a pen and write anything that came to mind: her name, Cameron’s name, Chloe’s name, anything to keep her mind from what was happening. When the feeling became too strong, she would ask for a break.
Judge Lupuloff was listening attentively throughout the case.
Lupuloff has a reputation for being a tough judge, one not known to be overly friendly in her courtroom. But Sahlein and Cummings were both impressed at the questions she asked them and how willing she was to immerse herself in the science they were presenting. Moreover, sometimes in serious cases such as fatalities, judges are reluctant to bear all the risk and are unwilling to take a different position than the child welfare agency bringing the case. But Lupuloff was not afraid. Then there is the pressure judges can feel to move cases along to make space for other cases. Lupuloff did not do that. Lupuloff, Cummings said, “was really what saved the case.”
In November 2013, a psychologist at the Albert Einstein College of Medicine’s Center for Babies, Toddlers, and Families assessed Chloe’s relationship with her parents in order to determine whether there was need for parent-child treatment. In January 2014, two months into the trial, she issued her report. Chloe, she wrote, “appeared cheerful, calm and focused…Both parents appeared delighted when [Chloe] was able to complete tasks and applauded. Chloe was soon applauding herself after completing tasks.”
Chloe’s “secure attachment behavior was very positive,” the report noted, “particularly in light of the fact that Chloe is not living with her parents.” No services were needed, the report concluded.
In February 2014, the court ordered that Jarayha and Jonathan be allowed unsupervised weekend visits. For the first time since Chloe was born, they could be alone together in their own home, from 5 p.m. on Friday evenings to 7:30 a.m. Monday mornings. Still, at least once during each weekend visit, Jarayha said, a child protective investigator would knock on their door in the middle of the night to make sure neither Jarayha nor Jonathan had harmed Chloe. They would undress Chloe, check her body for bruises, then leave. Jarayha said she hated that she didn’t have the power to protect her child from this routine, but she knew she had to allow it or risk losing Chloe again.
Four months later, Jarayha’s lawyers asked the judge to parole Chloe to her parents—arguing that there had been no evidence since Cameron’s death that Chloe was at any risk with them. In June 2014, Judge Lupuloff sent Chloe home, over the objections of ACS. The day she came home, Jarayha said, both she and Jonathan cried. When her daughter cried at night, Jarayha said, it was a relief to be able to be by her side to console her, not to have to do it over the telephone.
Once Chloe was home, said Horan-Block, Jarayha’s lawyer, no one believed the judge would take Chloe away from her parents again. What they were fighting for at that point was the restoration of Jarayha and Jonathan’s name. Still, the case dragged on for another year, with evidence and counter evidence being presented, and months of waiting in between.
Finally, on June 3, 2015, nearly three years after Cameron’s death, Judge Lupuloff dismissed all charges against Jarayha and Jonathan, telling the court that Cameron had been well loved and well cared for during his very short life, and that he had died because he was not meant for this world. Lupuloff said the evidence was overwhelming that Cameron had died from natural causes. She also noted that while the medical examiner had years of experience in her profession, up until Cameron’s case, she’d had no experience with Abusive Head Trauma or with Cerebral Venous Sinus Thrombosis. Lacking this experience, Lupuloff said, she had simply tried to fit a square peg into a round hole.
Jarayha and Jonathan, their relatives, and their lawyers hugged and cried. Even Lupuloff got down off the bench and asked if she could give Chloe a hug. Then she hugged Jarayha and Jonathan. Hugging the people in her courtroom, she told them, was something she had not previously done during all her years on the bench.
Despite Lupuloff’s ruling, and the subsequent removal of Jarayha and Jonathan’s names from the state’s child abuse registry, according to the NYC Office of Chief Medical Examiner, the cause of Cameron McCleod’s death continues to be documented as abusive head trauma and the manner of death continues to be listed as a homicide.
“The medical examiner is always open to new information, and the cause and manner of death may be amended based on that. However, the outcome of a trial does not influence the medical examiner’s findings,” Bolcer stated.
The debate over the diagnosing of abuse remains polarized into “protectors of innocent families” and “protectors of innocent children.” In part, this is because of how difficult it can sometimes be to prove or disprove child abuse in the way cases are typically proven in a court of law.
In the 1970s, when family courts were first being set up to deal with cases of abuse and neglect brought in by the newly created mandated reporting laws, court personnel quickly came to realize that in cases of child abuse, there were rarely witnesses to the crime, while often the victims themselves, if they were alive, were too little to testify or swear under oath. Even when they were old enough, often it was inappropriate to ask them to do so.
Because of this difficulty, family courts turned to a legal concept used in civil courts called res ipsa, which means, “the thing speaks for itself.”
“If a baby is fine in the morning, is with only his mother until lunchtime, and at lunchtime that baby has five broken bones of a nature a doctor says had to be inflicted, everyone agrees that parent should be held responsible,” explains Chris Gottlieb, professor at New York University’s Family Defense Clinic. The problem, Gottlieb believes, is that many situations are more complicated, and sometimes, in cases of injuries to children, people are just “so horrified at the idea that we might make a mistake and send a child home with a parent who did something,” that they overlook evidence that might suggest a child was not abused.
The worst-case scenario, Gottlieb says, is that the courts send a child home to a parent who winds up hurting that child. “We all dread that possibility,” adds Gottlieb. “But sometimes the evidentiary standard requires that we send a child home even though we are not and may never be absolutely sure what happened. That’s the policy that best serves children because separating a child from an innocent parent is also a terrible harm to inflict.”
Gottlieb continued, “If parents can show that they took the child to the hospital, that they made all possible efforts a parent could make to help the child, and that there are other plausible explanations for a child’s injuries—that doesn’t prove that they didn’t abuse their child—but that evidence does need to be seriously considered by the court. In the face of uncertainty, courts have to make the decision the evidence best supports”
One area where there is agreement is around the need for greater clarity about what science does and does not know when it comes to diagnosing child abuse.
In 2009, the National Academy of Sciences published a report about widespread errors in many areas of forensic science. Since the report, different branches of forensic science have taken steps to become more rigorous in their processes and trustworthy in their conclusions. After the report came out, people involved in the Shaken Baby controversy began discussing the need for a similar report.
Findley believes that in order to be thorough, a panel to create such a report would need to be made up of a wide range of experts from pediatricians, pathologists and ophthalmologists to statisticians, biomechanical engineers, psychologists who understand cognitive biases, and lawyers who understand how scientific findings apply in court. Findley says the biggest barrier is funding. Congress could pay for it, but with Congress in gridlock over so many issues, Innocence Projects have begun to look for ways to raise private money for such a report.
Robert Block of the AAP, too, says such a report would be welcome. “I think it would give us a chance to show, ‘This is an off-the-wall theory that every child we believe was abused really had a genetic disease. Or it might be something we think is indicative of abuse that is not as 100 percent indicative as we think it is.
“Our job is to get it right…A report of that stature would be helpful…I believe every child abuse pediatrician in the world in good standing would support such a report…And I think the academy and all the different academies would be behind it as well.”
For Jarayha, the ending of the trial means that she can allow herself to grieve for Cameron without also having to grieve for her daughter.
The day she and Jonathan were exonerated, Jarayha said, she went to Cameron’s grave and told him: “Now you can sleep in peace. Now you can go…Finally I cried. I let it all out. I said, ‘God had a better plan than I could ever give you.’”
Jarayha agreed to share her story because she wants to right the record. Up until now, Jarayha said, when you searched her and Cameron’s names on the web, the only thing that came up was the Daily News article declaring Cameron’s death a homicide.
“You feel like people see a young Black couple and they automatically think, ‘Oh, they’re not educated. They were raised with violence. They probably carry a gun,” said Jarayha. “They don’t think that you work honestly to take care of your children or know what kind of motherly instincts you have.”
Today, Jarayha enjoys taking her daughter on outings and laughing at the clever things she says. Recently, she was there to spend the first day of preschool with Chloe. When she is not at work, Jarayha said, wherever goes, Chloe goes too, as if they are just a little bit afraid to lose each other again.
Jarayha said she knows that when her daughter gets older she’s going to ask, “‘Mommy, what happened to Cameron?’ Nobody else, not a judge, not a lawyer, is going to explain it to her.’ I am happy that at least now I can talk about it without breaking down.”