In a trial for the deaths of the children of Iris and Malena, Rula Pispirigou is referred as announced in court by Alexis Kougias. In particular, Mr. Kougias announced to the audience that a summons was issued for his principal in order for him to be tried for the other two girls as well.

The trial of Roula Pispirigou at the Mixed Jury Court of Athens continues today in high tones once again with her lawyer Alexis Kougia examining the intensivist of the University Hospital of Rio Andreas Iliadis who had undertaken the nursing of little Georgina and had suspected, as he himself has testified, that the accused mother might be suffering from the disorder of Munchausen syndrome by proxy and for that reason might harm her child.

On the occasion of this reference by Mr. Iliadis that it was not possible to rule out the version that the accused suffers from Munchausen syndrome, the defense attorney requested the suspension of the trial in order for two expert psychiatrists to be appointed by the court in order to establish whether Roula Pispirigou suffers from this particular syndrome.

“This disorder is described in the literature. As I have said, the case of Munchausen disorder by proxy was also included in the differential diagnosis. And because this disorder is considered child abuse and I was the child’s treating physician I had to deal with little ones as I did,” said Mr. Iliadis earlier, who took the witness stand to be examined after Mr. Kougias had said before the start of the trial: “You are here to testify and not to give interviews like Katina. Before long you’ll be filing and crying.”

Kougias: Tell me if where you served you were concerned about whether a mother has this disorder…

Iliadis: I was in front of two incidents at Aglaia Kyriakou, when I was a pediatrician there.

Kougias: Did you or your colleagues raise the issue there?

Iliadis: I was a witness to these two incidents.

Kouyas: So you saw any mother kill her child?

Iliadis: I was present. This is personal data.

Kougias: What are you witnessing? And who raised the issue?

Iliadis: They were the same cases. One mother reddened the child’s urine with dye and said that there was hematuria. The rarity of these incidents does not leave us indifferent to not act.

President: A witness to what? More specifically.

Iliadis: I act like a doctor and that’s how I answer. I was a doctor at Paedon. This case was an admission to Pediatrics and was in the differential diagnosis. This is how the pigment was found in the child’s urine.

Kougias: Does this have anything to do with the urine and the accused? Should we see your lineup? Is this Munchausen syndrome?

Iliadis: Quite right, exactly. There is simply a gradation and if someone progresses to its most difficult form, we may even have the death of the child.

Kougias: Why is this Munchausen syndrome with the urine?

Iliadis: Because that’s what medicine says.

Kougias: Does this have anything to do with the accused and did you send her to psychiatrists and did you also have sessions? An apparently disturbed woman dyed her child’s urine. She obviously had problems of her own. Is this Munchausen syndrome?

Iliadis: Yes, they are in the same category.

Kougias: Who determines this? Tell me a psychiatrist in Greece who has diagnosed Munchausen syndrome in a mother…

Iliadis: It is a disorder that involves too many specialties from different positions. Psychologist, pediatrician, social worker, psychiatrist, prosecutor is quite complicated.

President: What he asked you, do you know how to answer? If there is a psychiatrist who has made such a diagnosis? Has a mother ever been brought to justice in Greece because she tried to hurt her child with Munchausen syndrome?

Iliadis: The literature is full of such incidents. You should see the guidelines for how careful we pediatricians have to be.

Kougias: Since you are told that you should be concerned about books and instructions, how many children have you helped?

Iliad: Thousands.

Kougias: What were your sessions with the psychiatrists about?

Chairman: Was it a session or a meeting? Did you go as a patient or as a doctor?

Iliadis: I went as Georgina’s doctor.

Kougias: He says in his testimony that he visited two psychiatrists.

Iliadis.: I went with my file, with all the child’s history and I told him my concerns. Because it is a difficult and delicate subject, I asked to discuss it. We talked for quite some time, it wasn’t a five minute date.

Kougias: Why did you have sessions? What role would you play? You are not in the environment of the accused.

Iliadis: The visit was about getting more information about this scientifically documented disorder. The closest person for that was the psychiatrist.

Kougias: In these sessions did you talk specifically about the accused? Is this allowed? Or is it a violation and should be checked?

Iliadis: Not only is it possible, but it is mandatory for every doctor who respects his oath. It is considered child abuse. Mother is sick and my goal was to protect Georgina.

Continuing to answer Mr. Kouya’s questions, the witness repeated that what motivated him regarding the accused mother were the deaths of the other two children of the Daskalakis family and the sudden seizure suffered by Georgina in Karamandanio.

Kougias: How often did you meet the mother?

Iliadis: Enough. Parents were informed for one hour each day.

Kougias: What were you talking about for an hour? You have a child with brain freeze under sedation… What briefing you gave them an hour every day.

Iliadis: There are so many and complicated issues concerning these patients that have to do with all human systems. All this needs to be explained to the parents and I was slowly explaining to the parents what they might be facing.

Kougias: Every day you told them the same thing…

Iliadis: I informed them according to the development.

Kougias: Why didn’t you tell them that the chance of the child talking, moving his legs is one in a million….

Iliadis: As we know so far about a patient under sedation, it is not possible to have information about what they are like afterwards. But every day there are new problems and we explained them. E.g. we had no diuresis this is a problem we faced.

Kougias: On which day did you tell your mother “you are not alone and we are with you”?

Iliadis: I don’t remember.

Kougias: Why did you say this to this “passive” mother and not to Mr. Daskalakis who was different as the witnesses say?

Iliadis: It is something I always tell parents and I want all parents to feel that they are not alone. If anyone reads how to approach these families… The recommendation is to be close to them. One situation does not negate the other. You may think of a possible disorder in the differential diagnosis but at the same time you need to be close to them.

Kougias: Since it crossed your mind that he might kill her, why did you teach the accused gastrostomy?

Iliadis: If it is possible? Now what does that have to do with it? You can’t help it….It’s an act that has to do with a patient’s medical condition.

Kougias: The child stayed 100 days. There was some discussion with you when you trapped them and sent them to the psychiatrist.

“Doctors don’t trap, they heal”

Afterwards, Mr. Kougias referred to a dialogue between Mr. Iliadis and Manos Daskalakis which was shown on a TV show, leaving clear clues that his dialogue with Georgina’s father was recorded by the witness. In fact, he requested that the full transcript of the specific show be presented to the court, while he emphasized that he will also request the re-examination of Mr. Daskalakis.

According to what Mr. Kougias reported in court, in this dialogue Mr. Iliadis – Daskalakis discuss about Roula Pispirigou’s visit to the psychiatrist, without her knowledge, with the doctor telling the child’s father “Rula needs help”.

Kougias: Is it allowed by medical ethics to send a woman to a psychiatrist by “trapping her”?

Iliadis: Doctors don’t trap, they heal. It is not rare that we send mothers to difficult situations… I visited the psychiatric clinic rightly because I wanted help.

President: What help?

Iliadis: The effort to “embrace” this syndrome is to get close to the caregiver and that’s what I did.

President: Did the mother leave by force?

Iliadis: No, I told her that it would be good and that in such cases we always help. She told me that the husband wants to come too. The next day they came to my office and told me that the appointment didn’t go well. Georgina’s father told me “my wife is not crazy”. I wanted to be examined for the syndrome.

Kougias: Mr. Daskalakis says in his testimony that the two of you were in this conversation and not that the accused also came. Did you have any other discussions with Mr. Daskalakis?

Iliadis: The conversation was with both of them.

Kougias: Did this dialogue that was presented with Mr. Daskalakis take place?

Iliadis: Yes, Mr. Daskalakis came and was very kind and told me that they will not go to the psychiatrist again.