Lindsay Clancy Trial: Psychiatrist Details Her Delirium and Handing Off Her Own Care

**Dr. Sejal Shah** (0:00)
This is live courtroom coverage of the trial of Lindsay Clancy from the Hidden Killers podcast in True Crime Today. Now, back to the courtroom.

**Kevin Reddington** (0:11)
All right, good afternoon, doctor. Hi.

**SPEAKER_3** (0:12)
I'm going to ask you to keep your voice up and speak into that microphone, all right?

**Dr. Sejal Shah** (0:16)
Thanks, Your Honor.

**SPEAKER_3** (0:16)
Thank you.
Thank you, Your Honor. Good afternoon. Can you please state and spell your name for the record?

**Dr. Sejal Shah** (0:21)
Sure. My first name is Sejal, S-E-J-A-L. Last name is Shah, S-H-A-H.

**SPEAKER_3** (0:27)
What's your date of birth?

**Dr. Sejal Shah** (0:29)
5-8-81.

**SPEAKER_3** (0:31)
What do you do for a living?

**Dr. Sejal Shah** (0:32)
I'm a psychiatrist.

**SPEAKER_3** (0:34)
Can you briefly describe your education and training background that qualifies you to be a psychiatrist?

**Dr. Sejal Shah** (0:40)
Yeah, absolutely. I did my undergraduate in Philadelphia, the University of Pennsylvania, followed by medical school at Jefferson Medical College also in Philadelphia.
Sure. I moved up to Boston to do my residency in psychiatry at Brigham and Women's Hospital and Beth Israel Deaconess, followed by a fellowship in consultation liaison psychiatry at Brigham and Women's Hospital and then stayed on as a faculty member.

**SPEAKER_3** (1:07)
Where do you work currently?

**Dr. Sejal Shah** (1:09)
I work at Brigham and Women's Hospital.

**SPEAKER_3** (1:11)
What is your role there?

**Dr. Sejal Shah** (1:12)
I'm associate chief of the division of psychiatry and medicine, leading the consultation liaison psychiatry service at Brigham.

**SPEAKER_3** (1:20)
What is the consultation and liaison service?

**Dr. Sejal Shah** (1:23)
Consultation liaison psychiatry is a subspecialty of psychiatry that works at the interface of psychiatry and medicine. We work both in the inpatient and outpatient settings. In this particular instance, we get called by other health care providers that may need help with their patients who have a question related in the psychiatric realm.
I would see a patient that's admitted to the hospital and help provide recommendations to the physicians and the rest of the care team that's caring for that patient.

**SPEAKER_3** (1:54)
So basically say at the Brigham, if a patient is being treated there and a medical doctor is treating them and thinks that they need a consultation with a psychiatrist, your department would be called.

**Dr. Sejal Shah** (2:05)
That's correct.

**SPEAKER_3** (2:07)
And how long have you been with the Brigham?

**Dr. Sejal Shah** (2:09)
19 years.

**SPEAKER_3** (2:11)
Now I want to direct your attention to January of 2023 Did you interact with a patient named Lindsay Clancy?

**Dr. Sejal Shah** (2:17)
I did.

**SPEAKER_3** (2:18)
And was that on January 29th, 2023?

**Dr. Sejal Shah** (2:23)
Yes, that was the first of a handful of times that I saw her.

**SPEAKER_3** (2:26)
And why did you meet with Lindsay Clancy on January 29th, 2023?

**Dr. Sejal Shah** (2:31)
So my team was seeing Ms. Clancy for a number of reasons, including for psychiatric safety risk assessment. She had come in reporting a suicide attempt, which is a common reason why my team would be called, is to continue to ensure that patients are safe when they're in the hospital. So we make recommendations about safety status, what can we do to help keep a patient safe. But then we also make recommendations related to medications.
So that's why my team was following her. So that was one of the reasons why I saw her on the 29th, is to continue that assessment. I was also called to ask a new question that day, a consult question on whether she is able to make the decision to change her health care proxy from her at the time husband to her parents.

**SPEAKER_3** (3:23)
And when you consult to help determine whether someone's capable of making a decision like that, changing their health care proxy, are you evaluating their medical decision making capacity?

**Dr. Sejal Shah** (3:37)
That's correct.

**SPEAKER_3** (3:38)
How do you go about doing that?

**Dr. Sejal Shah** (3:40)
So there's generally four parts to medical decision making capacity. The first is whether somebody's able to voice a choice and whether that choice is consistent over time. The second is whether they understand the situation under which they're making that choice. The third part is appreciation of the risks and benefits.
And the fourth part is kind of being able to reason or rationalize that information to be able to come to a choice and how they came to that choice.

**SPEAKER_3** (4:10)
Now, if you're doing this evaluation to determine someone's capacity to make decisions, would a traumatic brain injury factor into that evaluation?

**Dr. Sejal Shah** (4:21)
It could.

**SPEAKER_3** (4:23)
When you evaluated Lindsay Clancy, did you, was she able to voice a choice to you about who she wanted to be her healthcare proxy?