PHILADELPHIA — Over five weeks of testimony, Philadelphia prosecutors have painted Dr. Kermit Gosnell as an eccentric, detached boss who relied on untrained staff to perform abortions at his outdated, inner-city clinic.
But have they proven he murdered a woman and seven babies born alive? Or that the self-proclaimed do-gooder morphed into a greedy, criminally reckless businessman after returning to his downtrodden West Philadelphia neighborhood?
"There has been an incredible rush to judgment like I have never seen before," defense lawyer Jack McMahon told jurors in opening statements last month.
The defense is set to begin its case Tuesday if McMahon recovers from an illness that caused a delay Monday. The most intriguing question this week may be whether the 72-year-old Gosnell testifies.
He may want to give jurors a self-portrait similar to the one he gave the Philadelphia Daily News just after the 2010 FBI raid that shut down his 30-year practice.
"I wanted to be an effective, positive force in the minority community," Gosnell told the newspaper, explaining how he was an early supporter of therapeutic abortions and drug treatment in the late 1960s.
Trial witnesses have described an abortion clinic, and perhaps a man, growing increasingly chaotic over the years.
One staffer said Gosnell performed mostly first-trimester abortions when she arrived in 2000, and a few second-term procedures. But the breakdown started to flip, perhaps because first-trimester patients had other choices, while second-trimester patients did not.
The woman who died after a 2009 abortion had gone to several clinics near her Virginia home, starting when she was about 15 weeks pregnant. But each time, she was referred elsewhere, until she arrived at Gosnell's clinic in her 19th week. Bhutanese refugee Karnamaya Mongar, 41, died of a Demerol overdose the next day.
Gosnell's "nursing" staff included several women who were trained at a career school to be medical assistants, but were quickly shown how to perform ultrasounds and give anesthesia. To make the latter job easier, a 15-year-old worker used markers to draw up a color-coded chart that showed which drug cocktails should be given to which patients. Sometimes, it depended on how much they could pay, witnesses have said.
Prosecutors have filled the courtroom with Gosnell's office equipment, including a seemingly ancient ultrasound machine, a busted defibrillator and a ripped, aging examining table.
The 546 exhibits also include dozens of patient files, one of which was handled with latex gloves because of a still-odorous stain. And an FBI agent recalled Gosnell, on the night of the 2010 law enforcement raid, eating dinner while they interviewed him.
"He was still wearing his bloody latex gloves. They had some holes in them," Agent Jason Huff testified.
At the time of the raid, Gosnell had 47 fetuses stored in the freezer, authorities said, apparently because of a billing dispute with his medical waste company. The recovered bodies gave investigators a wealth of evidence to test, and prosecutors said in opening statements they could prove that at least seven babies were born alive.
Unlicensed doctor Stephen Massof and other staff members testified that Gosnell taught them to "snip" babies in the top of the spine after the abortion procedure.
"If you cut off the brain, the body will die. It's that simple," Massof testified.
Massof has pleaded guilty to two counts of third-degree murder.
"I trusted him. I believed he knew what he was talking about," said Massof, a Caribbean medical school graduate who could not get a U.S. residency. "I should have Googled."
Medical assistant Kareema Cross said she saw babies move even after their spines were severed. McMahon disputed that account.
McMahon is also expected to challenge prosecutors' claims that the autopsies of two of the recovered fetuses show they had taken a breath. The Philadelphia medical examiner stopped short of confirming that when he testified.
And only two of the 47 were arguably past the 24-week limit for abortions in Pennsylvania, McMahon has noted, attacking charges that Gosnell routinely performed illegal, late abortions.
Eight clinic employees have pleaded guilty in the case. The only remaining co-defendant, medical school graduate Eileen O'Neill, is fighting racketeering and false-billing charges, for allegedly billing as a licensed doctor.
Damber Ghalley, a relative who had driven Mongar to the clinic, saw Gosnell outside the hospital after she died.
"He said ... `The procedure was done. I didn't do anything wrong. I would be able to answer any person, anywhere,'" Ghalley recalled. "He did not express any sympathy."
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