Monday, October 18, 1999
Lemak used pills but not counseling to ease woesBY STACY ST. CLAIR,
Daily Herald Staff Writer
Marilyn Lemak blamed her nagging ailments on the divorce.
She believed the migraines, backaches, clenched jaw, stomach pains and irregular menstrual cycle all stemmed from her marital problems.
Her doctor agreed and prescribed Zoloft, an anti-depressant, to help her. Lemak began taking the drug in June 1998, according to court records.
She initially took 50 mg per day, a normal dosage for people battling depression. That prescription, however, would double over the next 10 months and expand to include the relaxant Ativan and Zantac, an ulcer medication.
Lemak, a surgical nurse, apparently substituted pills for psychological counseling, a common practice that her defense team will argue helped precipitate the slaying of her three children.
The Naperville woman stands accused of drugging and suffocating those children - 7-year-old Nicholas, 6-year-old Emily and 3-year-old Thomas - on March 4 in an act of spite against her estranged husband, David.
She has pleaded not guilty and plans to use an insanity defense.
In recent court testimony, Lemak's general practitioner described how he treated the then-41-year-old mother's depression. Dr. Robert Hubbard of Naperville painted a troubling picture of a woman who complained constantly about divorce-related stress but planned to overcome it primarily with drugs and a YMCA support group.
Marilyn Lemak filed for divorce June 1, 1998, claiming her husband was "guilty of extreme and repeated mental cruelty." Three days later, court records show she was in her doctor's office complaining about the separation.
Hubbard prescribed Zoloft to help her cope, a move not uncommon by general practitioners, and one that appears to be on the increase.
Family doctors account for more than 50 percent of anti-depressant prescriptions in the United States, a recent Rutgers University analysis shows.
Five years ago, the same research shows, 11 million psychiatric appointments included an anti-depressant description, while primary-care physicians wrote 10 million anti-depressant prescriptions.
"It has become very common," said Stephen Crystal, a Rutgers researcher who studies prescription trends at the New Brunswick, N.J., university.
Crystal and other medical experts partially point to HMOs for the trend, which emphasize care by family doctors.
General practitioners have grown more comfortable using drugs such as Zoloft. Unlike earlier anti-depressants, studies show the pill possesses fewer dangerous side effects. Chances of overdoses and toxicity also are rare, Crystal said.
"These drugs are generally considered safer," he said.
A month after starting on Zoloft, court records show Lemak returned to Hubbard's office and bemoaned her crumbling marriage. She wanted her husband to move out, but he steadfastly refused.
The doctor testified he increased her dosage to 100 mg per day. Most Zoloft users take between 25 mg to 200 mg daily, experts said.
Lemak claimed to be in better spirits when she saw Hubbard again in August 1998. She said her energy level had increased, though she still felt stressed.
Hubbard boosted her intake to 150 mg per day, which both Pfizer and medical experts consider to be on the high-end of safe Zoloft prescriptions. By year's finish, the doctor testified he had placed her on Ativan and increased her Zoloft intake to 200 mg per day.
On a chilly March afternoon a few months later, those same drugs would be used to kill the Lemak children.
Authorities say Lemak crushed the pills, sprinkled them atop peanut butter bagels and fed them to the children. Once they were sedated, police say, she suffocated them by pinching their noses with one hand and covering their mouths with the other.
She then swallowed "two or three" Ativan and hoped to die, according to court documents.
At the time of the murders, Lemak was supposed to be taking 200 mg of Zoloft each day. Experts consider the dosage to be safe, though some question why Lemak wasn't in counseling if she required such heavy medication.
"It's a high level," said Peter Breggin, author of "Your Drug May Be Your Problem" and a faculty member with the Johns Hopkins University department of counseling. "A counselor should always be consulted first, but more and more we're seeing general practitioners do this."
Why Marliyn Lemak didn't seek professional counseling remains unanswered, at least publicly. Court records show the surgical nurse was no stranger to therapy.
During a 1998 divorce proceeding, she testified she urged her husband to see several marriage counselors as their relationship crumbled.
Yet when it came to treating postpartum depression - which she experienced after Emily's and Thomas' births - and divorce-related stress, her attorneys say she turned to general practitioners.
The closest Lemak came to therapy during her marital breakup was a YMCA support group, which she joined in January.
Lemak defense attorney Jack Donahue declined to discuss his client's medical care in the 10 months leading to the children's deaths.
"All I can do is tell you she was getting no counseling," he said.
Donahue, however, is expected to call expert witnesses who will scrutinize the decision to give Lemak pills instead of therapy. The defense long has portrayed the Naperville mother as a delusional woman who spiraled into the darkest depths of despair and isolation.
It's an image that law-enforcement officials say they find implausible. In court documents and interviews, they have described Lemak as vindictive, manipulative and bitter.
Authorities contend a delusional person could not have carried out such methodical murders. They say if Lemak were hallucinating, she could not make the drug-laced snack, put the children to bed and smother them one at a time.
And, they argue, someone that distraught probably could have carried out her own suicide attempt.
Law-enforcement officials also point to friends and family who say Lemak handled her daily chores with ease: walking the kids to school each day, attending Pampered Chef parties, and helping run clothing drives.
Nobody realized the path Marilyn Lemak was taking - not even her doctor, based on court records.
Lemak last visited Hubbard on March 2, two days before the murders. A month earlier she had complained to Hubbard about her husband's new girlfriend, but now she told him she had finally accepted the situation.
She also announced her decision to give up Ativan, which she was taking twice a day. The Naperville mother told Hubbard she soured on the drug after she did not immediately wake up one night when her sick child cried for her.
"She finally accepted the situation," Hubbard wrote in a report. "And that is the biggest help to her."
Two days later, Hubbard visited Lemak at Edward Hospital, where she was taken after confessing the children's murders to a 911 dispatcher. When the doctor asked what had changed in the past 48 hours, Lemak told him she saw her husband with his girlfriend the day before.
Lemak appeared catatonic during early court appearances, but now seems alert and responsive. Her defense lawyers credit new medication with her improved condition, though they will not name the drugs.