Pam's story: Child abuse case builds (Part 3)

Part 3 of a 6-day series

The morning after he tried to kill himself, sixth-grader Zack Kazmaier talked to Mesa police from his hospital bed.

What first appeared to be a double suicide attempt was fast becoming a child abuse case, or maybe even attempted manslaughter.

A 6-part series

Sunday: Together in death

Monday: By the book

Today: Troubled pasts

Wednesday: “I am not their servant”

Thursday: New hair, new underwear

Friday: “You don’t throw people away”

Cherie Leffler, specially trained to interview children, asked the boy what happened. He didn’t respond, so she asked again. How’d you wind up in the hospital?

“I was trying to commit suicide,” he replied.

Does he know what suicide means?

“It means to kill yourself.”

Why would you want to do that?

“ ’Cuz life is so hard,” Zack said.

Zack told Leffler he had a mental illness and kids made fun of him and he struggled in school. He said both he and his mom wanted to die. Then he started crying so hard that Leffler couldn’t understand him.

At different times during the interview, Zack said he “just grabbed handfuls” of pills, took 102 pills and just took “all four pills of (his) night medicine.” According to her report, Zack also told Leffler his mother was going to use a razor blade to slit their wrists but he didn’t want to.

Pam Kazmaier said later she and Zack were standing in the kitchen when he held up his wrists to her, asking her to cut them. The former nurse said she couldn’t do it, so they got their pills, went into the bedroom and swallowed them.

Zack said he still wanted to die — that he was mad at his dad and big brother Mike because they “wrecked it.”

“Me and my mom would have made it to heaven.”

The interview with Zack, together with notes found in the bedroom written by him and his mother, were key pieces of evidence for police and prosecutors as they built their case against Pam.

The long, tortuous mental health histories of mother and son were about to come into view.

Both had bipolar disorder, also known as manic depression, characterized by wild mood swings from elation to depression. In addition, Zack, 12, had a learning disability and read at about the second-grade level. He set fires, jumped off buildings, threatened to blow people up, put ropes around his neck and routinely said he wanted to die.

Pam had been raised by two mentally ill parents and had lost a nephew to suicide. She heard voices as a teenager but wasn’t diagnosed until her 30s, after she married and had two small boys.

She quit her longtime nursing career to focus on Zack after his difficult birth. It was the beginning of what doctors would later call her “enmeshment” with her younger son and his many difficulties.

They each took three types of pills daily — antidepressants, mood stabilizers, anti-anxiety medications — and had agreed on that sunny September morning to take extra and go to sleep. For good.

For Zack, it was a way out of a confusing, unpredictable and — despite his parents’ best efforts — painful existence. For Pam, who hadn’t had a good night’s sleep since Zack was born, it was a way to get some rest.

But that’s not the way the law saw it.

A month later, a Maricopa County grand jury was told Zack and his mother talked about committing suicide on their way home from church, that Pam “first approached him with taking razor blades and cutting their arteries” and that Zack could have died from the drugs he took.

None of that turned out to be true, but on Oct. 23, 2003, the jury returned an indictment against Pam on a charge of second-degree child abuse.

She was facing a huge legal bill if she went to trial, and the possibility of 30 years in prison if convicted.

After a day, Zack was moved off the pediatric intensive care unit to the general pediatric ward. The next day, he was transferred to St. Luke’s Behavioral Health Center in Phoenix.

There, doctors realized he’d been on the wrong medication — exactly what Pam had been trying to tell his psychiatrist, and anyone else who would listen.

But this was 2003, before bipolar teens on antidepressants started dying. Before the federal Food and Drug Administration started investigating the deaths. Before the FDA required drug makers to affix “black box” warnings on antidepressants like the one Zack was on that said, in essence, your child may want to kill himself if he’s taking this drug. Zack was put on an anti-psychotic drug that was, for him, transformative and that, four years later, is still effective.

As Pam would say later: “The wrong medication is deadly. The right medication is life-changing.”

But in early October 2003, while her son’s life was changing for the better, she was about to go through hell.

ABOUT PAM’S STORY:

Information contained in these stories comes from court records and hearings, hospital and medical records, police reports, school records and interviews with the family and others involved in Pam Kazmaier’s case and her life.

About bipolar disorder

Bipolar disorder (also called manic depression, bipolar affective disorder) is characterized by periods of excitability (mania) alternating with periods of depression. The mood swings between mania and depression can be very abrupt.

It occurs equally among men and women, and there is some family connection. Bipolar disorder results from disturbances in areas of the brain that regulate mood. There is a high risk of suicide with bipolar disorder and a tendency to abuse alcohol or drugs, which can worsen symptoms.

Symptoms: During the manic phase, a person may be overly impulsive and energetic. Symptoms include racing thoughts, hyperactivity, lack of self-control, inflated self-esteem, reckless behavior (spending sprees, binge eating and drinking, sexual promiscuity), little need for sleep or short temper.

The depressed phase may bring feelings of anxiety, low self-esteem and suicidal thoughts. Symptoms include persistent sadness, listlessness, sleep and eating disturbances, loss of self-esteem, feelings of hopelessness, worthlessness and guilt, withdrawal from friends and activities or persistent thoughts of death.

Source: National Institute of Mental Health