Medicine is rarely black and white; it exists in innumerable shades of gray. Online commentary seems to treat PPP as a strict binary, but clinical pathology is complex. PPP could be 99.9% of the cause, or it might be the final 0.1% that tips someone over the edge when combined with baseline vulnerabilities like bipolar disorder (itself a complex spectrum disease deeply intertwined w/ PPP). Add severe insomnia to the mix—progressive sleep deprivation reliably induces psychotic features in anyone (so dangerous that Guinness officially banned sleep deprivation records). Then, add antipsychotics & other psych meds at previous times, and the clinical picture becomes almost unfathomably complex. I usually despise using anecdotes to make a point, but I’ll share this because it parallels the discussions around this case. A woman I personally knew with four kids developed PPP. She hanged herself… homecoming queen, nurse, seemingly perfect life, etc. For weeks, she exhibited symptoms, but her husband insisted on handling it through their Catholic church rather than seeking medical intervention. It sounds like LC was also trying to get help via her clergy. The alternative hypothesis requires believing that an experienced neonatal nurse rationally planned the deaths of her children, expected to escape responsibility, and then intentionally made an extraordinarily dangerous suicide attempt. You don’t have to claim that proves psychosis; it simply belongs in the totality of the evidence. ……Or, we are supposed to believe that this nurse who cared for infants all those years was fully in her right mind, playing 5D chess and thinking she was going to get away with murder via a "faux" suicide attempt—diving headfirst out of a 20-foot window and paralyzing herself for life. She should clearly now be held fully responsible and burned at the stake. 🤔 Bottom line: I don’t know exactly what happened, and neither does anyone confidently diagnosing her—or declaring her completely sane or not—either in that court room, media, or elsewhere. That’s precisely my point. Psychiatry, causation, capacity, and criminal responsibility are extraordinarily nuanced questions requiring the complete clinical record; a life resume alone cannot make a determination in this case. Most people discussing this case literally no nothing about medicine. If people have strong beliefs about what happened here, I would suggest they examine why they have a predisposition to those beliefs, as they are likely having difficulty with their ability to evaluate the facts objectively