7-13-1996 Joel Nance MD

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    July 13, 1996

    Ms. Claudine Dombrowski

    Box 304

    Lamed, Kansas 67550-0304

    To Whom It May Concern:

    J U L 1 9 1 9 9 6

    I met with Ms. Claudine Dombrowski at her request for three hours on May 14th, 20th and 23rd.

    Ms. Dombrowski is a thirty-one-year old Licensed Practical Nurse. She specializes in psychiatry, and

    recently finished a position at Topeka State Hospital which she held for three years. Her daughter, Rikki,

    was born on December 12, 1994. Ms. Dombrowski is in the process of seeking a divorce from Hal, her

    second husband, whom she marned in October 1995. They had seen each other for two years before that;

    during which time she was unaware that he was marned to another woman. She states that he divoreed his

    first wife in September of 1995. Ms. Dombrowski consulted with me out of the concern that her husband

    was lr)ing to force a serious custody dispute by claiming that Ms. Dombrowski was emotionally unstable;

    she wanted to have a professional assessment by a neutral party "ith which to respond to that accusation.

    Ms. Dombrowski gives the following history. She was born in Beloit, Kansas, but her family soon moved

    from there. She has few early childhood memories. The first is of a Christmas time: she and her brother

    were chasing each other around the house. She was often ill and in the hospital as a child, and suffered some

    damage to her right kidney due to ureteral reflux from her bladder. Eventually she had surgery for this, the

    ureter was re-implanted and the kidney recovered.

    She was in foster care during many of her early years. She is not entirely sure why this was, but believes that

    she was caught in some sort of triangular issues betwccn her parents. She has a sense that some similar

    process is occurring now as she and her husband try to sort out their relationship as divorcing parents, and is

    determined that Rikki not be harmed by this.

    Ms. Dombrowski' s memories become clear and continuous at about the age of 12, when she was restored 10her mother's care. She remembers starting to get interested in boys that year. Her mother wanted her to wait

    until she was 16 before beginning any relationships. Indeed. she had her first boyfriend at 16; they would

    hold hands and he earned her books to and from school. She did well in school at all levels through

    achieving her LPN. She often made grades of A "ithout opening her books simply by taking in the

    classroom material.

    Ms. Dombrowski entered the United States Army National Guard in 1983 at the age of 18. She had a six-

    month training period followed by three years' active service. In 1992 she joined the army reserves, and

    served one year of active duty, from January to December of 1994, to learn nursing. She enjoyed this until

    her child was born. Shortly after this event she left the military because of their requirements that she come

    in on weekends and odd hours which were incompatible with earI)ing for a newborn child. lIn deed. this was

    a child who had some early special needs. Rikki had been born at 36 weeks' gestation after a period of

    maternal hypertension and oligohydramnios. and was small for gestational age. She spent seven days in the

    newborn ICU before going home.] Rikki is now doing very well, and Ms. Dombrowski, a proud mother

    indeed, showed me a number of photos of her daughter in robust health.

    It is worthy of note here that in addition to having spent many of her early childhood years in foster care, Ms.

    Dombrowski lost her first four pregnancies through spontaneous miscarnages. These events have made

    issues of parenting and of the bond between mother and daughter more intensely loaded for her then might

    othemise be the case.

    EXHIBIT

    , / c J . .

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    It should also probably be noted at this point that some circumstantial medical evidence recently came to

    light which has led to questions whether Ms. Dombrowski might ha,'e been sexually abused during one of

    the foster periods. Ms. Dombrowski has no recollection of having been abused, and may well not ha,'e been;

    however, the possibility exists that something!!!ID: have happened to her which could have intensified her

    awareness of dangers a young daughter might face alone in the custody of a man: even her O\m father.

    We discussed the ,'ery bitter relationship with her estranged husband. She reports that he has a problem

    with feelings of jealousy which she says are unfounded, and which scem to have come to a state of violent

    intensity during her pregnancy with Rikki. She states that she did not know that her estranged husband wasmarried until she was three months pregnant with Rikki. She further says that she had no notion of his

    potential for violence until she was five months pregnant. This was when he struck her for the first time.

    She declined to call the police after \"iolent incidents until after Rikki was born, but reports that she had a

    black eye from his abuse at the time she ga\"e birth to Rikki. She also reports that in her pre\"ious marriage,

    which lasted seven years, there was no abuse or physical fighting whatsoe\"er. Thus, she has not had a

    pattern of seeking out abusiv'e or physically contentious relationships. She readily volunteers that she did

    defend herself physically from hcr husband's attacks. This was especially true ifshe felt that her husband

    was unaware of the proximity of thcir child to scenes of violence. At such times, she felt fearful that Hal was

    so out of control that Rikki might be inad\"ertcntly harmed.

    Ms. Dombrowski recounts a number of ways in which shc came to be frightened of and by her husband's

    beha\"ior. I will leave it to Ms. Dombrowski to recount the details of these experiences, but the material is

    certainly of the nature that would \"cry appropriately result in a justified sense of personal danger,

    traumatization, and \"ery powerful emotional distress.

    Ultimately, Ms. Dombrowski mo\"ed out of the marital home and spent two weeks at the Battered Women's

    Shelter with her daughter. She found the program \"e!)' helpful, and misses it and the people she met there.

    Ms. Dombrowsk; has now taken a job in Lamed with the Department of Corrections, working in Youth

    Ser\"ices as a Court Sef\"ices Specialist. This allows her to be near her mother, who pro\"ides some help with

    child care while Ms. Dombrowski is at work.

    Ms. Dombrowski is a well nourished, well developed woman who appears her stated age. Her positi\"e,

    energetic and engaging character came through strongly throughout these inter\"iews. She is well endowed

    intellectually, and her thoughts are well rooted in reality. She maintains a logical, lucid, undisturbed train of

    well-reasoned thought at all times. There is a tendency to experience frequent moments of anger at herhusband, and the first inter\"iew was focused on her feelings toward her husband, and the legal system's

    paradoxes and una\'oidablc delays. Thesc frustrations secmed quite consistent with her situation. Despite

    times of anger and dismay about the events of the past few months, she maintains her good sense of humor

    throughout and is altogether a \"e!)' pleasant and cordial person to interview. Her affects are appropriate to

    the material undcr discussion. The inquiry into vegetative signs and s)mptoms such as sleep disturbance,

    appetite disturbance, difficulties with mood and affect and so on re\"eals only relati\"ely minor and transient

    effects. These are more than adequately explained by residues of her traumatic experiences, as well as her

    current task of extricating herself from a devastating marriage and putting her life back togethcr again. She

    denies any sort of\'isual or audito!)' hallucinations, delusions or unusual convictions. She has had no

    experiences of "lost time," nor of rmding notes to herself in strange handwriting, or disco\"ering that the

    furniture in the house has bcen rearranged without her being aware of it. She does not experience herself as

    de\"eloping intense positive and negati\"e splits betwcen different people into "good" and "bad" groups, and

    says "I like people, and people like me." She has no significant histo!)' of head trauma except for her report

    ofha\"ing been struck by her husband with a crowbar during an argument. There was no loss of

    consciousness at that time, and she has no other history of loss of consciousness, seizure or absence attacks.

    She states that she ordinarily is a light user of alcohol, and describes her usual intake as one glass of wine

    with dinner, two to three times per week. She has discontinued this practice at the suggestion of her

    attorney, since her husband accuses her of being an alcoholic.

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    One area in which Ms. Dombrowski may not have served herself as well as she might was in the area of

    working collaboratively with her prC\.ious attorney. She reports what to me seemed a sensible

    recommendation from this attorney (not to move her residence from Topeka without first seeking the court's

    approval), which she did not follow. While the reasons for the action she took (to reduce the level of stress

    on herself and her daughter) are clear she might have been better served had she worked more closely in

    alliance with her attorney and found a way to tolerate this sort of minor delay, which is inevitable in any

    legal undertaking. [I have subsequently learned that the Courl had no problem with the move.] Another

    issue which Ms. Dombrowski is working on is her tendency to be intensely focused on and extremely

    protective of her daughter. This is an understandable tendency on her part given some of her 0\\11

    experiences in childhood and her impression that her estranged husband has at times been oblivious to

    potential harm to Rikki. It is an area of which she is perfectly well aware. She brings it up on her own

    initiative as a working issue, and is addressing it actively to fmd a more comfortable balance. 1do not

    believe that the degree of involvement and concern she describes raises any major or worrisome concerns

    regarding her relationship with her daughter, or about her daughter's well-being. My impression overall is

    that she is a fine, highly competent, deeply caring and attentive mother. From a psychiatric perspective, I

    can see no basis on which Ms. Dombrowski's mental or emotional competence. should for any reason playa

    part in any questions of custody that might arise in the course of her divorce from her husband.

    I hope that this information is helpful in any area to which Ms. Dombrowski brings it for consideration.

    Please feel free, with the appropriate release of information, to contact me for any further information you

    should need or desire.

    Sincerely,