The result is “Two Families, Two Fates: When the Misdiagnosis is Child Abuse,” a joint project between The Marshall Project and The Atlantic. Clifford dug into the role of child-abuse pediatricians. They’re specialists with a well-intentioned role: ruling out causes other than child abuse when children receive medical treatment for injuries. But as Clifford’s story shows, they have enormous influence in the family legal system, and a misdiagnosis can mean horrific accusations — and heartbreak — for families.
Clifford writes: “But child-abuse pediatricians may have a conflicted perspective. Many are paid in part by child-welfare departments and work directly with state lawyers in cases where the state is removing children from homes, and end up shaping arguments against parents, testifying in court, and working within a system that parents don’t understand is stacked against them. This is particularly problematic because child-removal cases play out in family court, where the state’s burden of proof is low and parents have limited legal rights.”
Clifford formerly covered courts and business for The New York Times. She’s written extensively on wrongful convictions and her recent magazine work includes a profile for Elle magazine of the first female federal prisoner known to die from COVID in custody. (The woman was seven months pregnant when she was transferred from jail in her native South Dakota to a prison in Texas. She was on a ventilator when she gave birth to her sixth child in a federal medical center, and died less than a month later.)
Despite Clifford’s experience, she still finds surprises in the country’s labyrinthine legal system.
“(A source) was talking about the cases they were seeing and mentioned child-abuse pediatricians. That was a new term to me,” Clifford said. “As a member of the public, I had no idea this was a specialist, no idea if I brought a child to the emergency room I may encounter a child-abuse pediatrician … It seemed like there was potential for things to go wrong. It seemed it could have more weight than even doctors intended.”
A team effort
With that single moment as a spark, Clifford embarked on an investigation that took more than a year from start to publication. With the help of the data team at The Marshall Project, Clifford delved into a sea of data: hospital contracts, federal court cases, civil cases and demographic data; Weihua Li played an especially important role in finding crucial data, Clifford said.
While data anchors key points, the story isn’t dry. Clifford profiles two families harried by abuse accusations that later fell apart under scrutiny; one parent was jailed before charges were eventually dropped shortly before trial. Most of the story’s visceral photographs were taken by Lawrence Agyei.
Clifford credits colleagues at both publications for bolstering the story, including Susan Chira, editor-in-chief at The Marshall Project; Ruth Baldwin, also at The Marshall Project; and Gillian B. White at The Atlantic, who Clifford said played an important role in shaping the historical aspect of the story.
“It was a collaboration, and it was such a great team,” Clifford said.
After the story was published, Clifford has heard from other people who had similar experiences to those profiled: parents separated from children and children who, years ago, were separated from their parents. It was, she said, both satisfying and upsetting.
“I heard tale after tale about families who are going through this,” she said “They didn’t realize it was happening to other people.”
Clifford’s experience reporting and writing holds potential lessons for other journalists, especially those challenged by complex, data-driven stories. Her comments have been edited for length and clarity.
Build a system to organize notes
While researching a story of national scope, it would have been easy for Clifford to be buried under a blizzard of court documents. The total documents comprised thousands of pages; the blood-test documents alone spanned hundreds of pages.
To keep from being overwhelmed, Clifford developed a system: She created a chronology to follow developments of the cases she was exploring; within the chronology, she carefully noted which documents key information came from, as well as quotes she’d likely want to include in the story.
“Each timeline tied to a medical or court document,” she said. “In cases like this you’ll get pages and pages of documents and if you don’t have a system you’ll lose your mind really quickly.”
Don’t lose site of the story focus
It’s easy for a journalist to lose the thread of even a seemingly simple story — never mind the hedge maze of conflicting accounts and court documents Clifford faced.
“I’d reported most of the story, but I’d been working on it so long I lost the thread of it,” Clifford said. “Sometimes you get so much information it gets muddled.”
Luckily, Clifford has a former colleague with whom she often discusses ideas or doubts.
“I had dinner with a friend from the Times who’s a great reporter, and I said, ‘I don’t know if this is a story anymore. I don’t know what it’s about,’” Clifford said. “She said, ‘Go back to when you pitched the story. What were you excited about?’”
Clifford recounted the initial idea.
“Yeah … that’s a good story,” Clifford’s friend assured her.
That one conversation helped her re-discover the heart of the story.
Find tools that work for you
In addition to her work as a journalist, Clifford is a novelist. Her novel “Everybody Rise” won praise from Entertainment Weekly and Time. Writing that long a story — almost 400 pages — had an unexpected benefit: She now uses novel-writing software for her longer journalism pieces as well.
“I’ve tried using Scrivener,” she said. “It’s meant for novels and non-fiction books, so you’ll have an outline and different windows in your main screen where you can see different sections. I usually do three drafts: one very, very rough one with an unlimited word count … it’s invariably three times so long, so I start cutting and filing down and seeing what the main points are.”
It’s a useful reminder: Journalists may not be novelists — or songwriters or poets or public-relations experts — but can use tool that helps them communicate more clearly.
Be upfront with sources
Clifford interviewed parents who’d been wrongly accused of horrific crimes. She wanted their voices in the story but wouldn’t cut any corners to get them. She made sure each subject knew what they’d be agreeing to with an interview.
“I want them to go in with eyes wide open, so they understood it would be in print, that we’d fact-check it … but that I’d be asking a lot of them,” she said.
Clifford shared previous articles she’d written so potential sources could see the kind of work she’s produced.
“You say, ‘Here’s what I’ll ask from you, and see if they’re willing,” she said.
Trevor Pyle is a staff writer at the Skagit Valley Herald, a daily newspaper north of Seattle. A longtime Washington state resident, he has covered education, news and sports in his career.