Pretty, prosperous and sunbaked, the small city of Sarasota sits on Florida's Gulf Coast, a world away from Miami's glitter and vice. On Main Street, the county courthouse and the First Church of Christ, Scientist, are just two blocks apart.
In April, 1989, the worlds that the two buildings represent collided. Two Christian Scientists were put on trial for murder after their 7-year-old daughter died of diabetes without ever having seen a doctor. At stake were two abstractions -- the parents' right to religious freedom vs. the state's duty to protect the lives of its citizens.
The debate received renewed national attention recently when a suburban Boston couple, Ginger and David Twitchell, who are Christian Scientists, were convicted in a week-long trial of manslaughter for relying on prayer rather than medical treatment to heal their 2 1/2-year-old son Robyn, who died of a bowel obstruction in 1986. The Twitchells have appealed their convictions.
Like the Twitchells, William and Christine Hermanson were solid citizens. Bill Hermanson was a vice president of the United First Federal Bank, Chris the founder of a music and art school called the Sarasota Fine Arts Academy. They lived with their two children, Amy and 9-year-old Eric, on a quiet cul-de-sac with a pool in the back yard.
The facts of their case were never in dispute. The trouble was fitting them together.
Fact 1: The Hermansons were loving parents, deeply devoted to their children.
Fact 2: Beginning in the fall of 1986, it became clear that something was wrong with Amy. The bright, bubbly second-grader was weak and losing weight -- 10 pounds in two weeks, says a relative. "Her eyes were sunken into her head so badly," a family friend recalls, "she looked like a skeleton."
Fact 3: If Amy had been taken to a doctor, her diabetes could have been diagnosed and treated. Until hours before the end, a shot of insulin would have saved her life. But the Hermansons, like the Twitchells in Massachusetts, chose to treat their child exclusively with "spiritual healing" -- prayer. Through the long night of September 29, when Amy was delirious and vomiting, they did not call a doctor. Amy died the next day.
How could the Hermansons have let it happen? Why wouldn't they abandon the religion that exacted such a price? Those questions are the first ones that outsiders wanted answered. But the Hermansons themselves seemed untroubled by doubts. Throughout the three-year ordeal leading up to the trial -- during the child-abuse investigation triggered by a relative's phone call and then one legal wrangle after another -- the Hermansons appeared serene, secure in the knowledge that they had done all they could for their daughter.
In the days after Amy's death, the Hermansons explained to relatives and colleagues that they hadn't deprived her of medical care -- they'd simply relied on a different method of treatment, one recognized by the state of Florida. At a family meeting the night after Amy died, her uncle recalls, "Bill sat there with an itemized sheet of all their procedures, saying how they did everything according to the law."
Chris Hermanson conceded that she had cried, and that she would probably cry more in the coming weeks. But three days after Amy's death, a friend paid a condolence call and found herself being consoled. "Chris told me, 'Amy fully knew that the choice was hers, whether to live or die,' " the friend remembered. " 'Amy glimpsed something from the other world, and she wanted that more than she wanted this world.' "
Now, to their bewilderment, the Hermansons faced a judge and jury. "Since Amy died, more than a hundred children who weren't Christian Scientists have died of diabetes," a church spokesman said in Sarasota. 'What does society do for their parents? It offers them compassion and sympathy. It doesn't put them on trial for murder." 'You Don't Just Sit and Pray'
Deno Economou, the assistant state's attorney prosecuting the Hermanson case, is thin and boyish-looking, swallowed up in a suit that looks as if he has borrowed it from his big brother. Most of his cases have been straightforward -- "This bullet came from this gun, and that man was a witness," in Economou's own summary -- and he doesn't want this trial to become a debate on theology. He has a tricky role to play, for he has to avoid giving the appearance of bullying the bereaved parents. His mild manner and physical slightness help, as if they've been designed to counter any perception that the state is an overbearing colossus.
The defense is headed by a courtly, silver-haired Southern gentleman named Edward Booth Sr., a generation older than Economou and elegant in his pinstripes. Also at the defense table, immobile and impassive, sit the Hermansons. Bill Hermanson is squat and balding, a fire hydrant in a blue suit. His wife cuts a more sympathetic figure, with the approachable air of an elementary-school teacher. It is easy to picture her giving piano lessons, always patient, encouraging and cheerful.
The attorneys begin by methodically marshaling the facts. It is nuts-and-bolts testimony: The prosecution calls an authority on diabetes to testify that a shot of insulin could have saved Amy's life. The medical examiner details her body's final breakdown. The defense calls a character witness to confirm that the Hermansons are all they appear to be -- kind, sincere, good citizens. He explains that far from neglecting Amy, the Hermansons had enlisted the help of a licensed Christian Science practitioner and nurse, both trained in spiritual healing.
In the front row of the spectators' gallery, one woman watches with especially keen interest. Rita Swan once shared the Hermansons' faith in God's healing ways. Then in 1977, her 15-month-old son, Matthew, contracted bacterial meningitis and died. The authorities in their hometown of Sioux City, Iowa, never charged them with any crime.
But Rita and Douglas Swan decided at once to leave the church. More than that, they founded a group called CHILD -- Children's Healthcare Is a Legal Duty -- to promote the view that parents have an obligation to provide their children with medical care, no matter what their own beliefs.
During a break in the trial, Rita Swan is asked about her former faith. "You want to know how I could have been sucked into it?" she says, interrupting her questioner. "You want to know how an educated person buys it?"
She has told her story often, but beginning it anew requires an effort of will. "My husband and I were lifelong Christian Scientists until 1977, when Matthew became seriously ill. He had three terrible fevers about a month apart, and each time we called a Christian Science practitioner. She did her prayer work, and each time he got well. To us, that was evidence that Christian Science did heal disease. We had no conception that the fever was a sign of infection, that the fever could come and go, but the disease would go on.
"In June, Matthew got his fourth terrible fever. He couldn't walk, he couldn't sit up, he couldn't smile. We called the practitioner again. She would admonish this 15-month-old baby lying there zonked out with fever: 'Matthew, you can't be sick. God didn't make disease, you make disease, and you live in the Kingdom of God.' "
This is standard Christian Science doctrine: Illness is a delusion, a false belief. Rita and Douglas Swan had accepted that view all their lives, and they knew almost nothing of biology or medicine. Douglas Swan, a PhD in mathematics, thought that fevers were caused by fear.
"Ten days into the illness, Matthew began screaming in the night," says Swan. Still, the practitioner was unfazed. "Poor Matthew was deranged, he was moaning incoherently, having convulsions, he couldn't blink his eyes," Swan recalled bitterly. "The practitioner reinterpreted everything. 'Maybe he's gritting his teeth because he's planning some great achievement,' she told me. 'Why not take the positive interpretation?'
"On Thursday, June 30, after he had been delirious for three days, we took Matthew to the emergency room because the practitioner said he might have broken a bone." Using doctors to set bones is one of several routine exceptions to Christian Scientists' reliance on spiritual healing.
"I walked in with this nearly dead baby in my arms, and they said, 'How long has this child been like this?' " The question struck Swan as a revelation. "How could life be so simple, that when a child is sick you do something about it? You don't just sit and pray."
Without antibiotics, bacterial meningitis nearly always causes death or severe brain damage. With antibiotics, the cure rate is around 90 percent. Doctors performed emergency brain surgery on Matthew Swan but told his parents afterward that they didn't think he would live and didn't know what he'd be like if he did. Matthew died after a week in intensive care.
That was 13 years ago. "Our son died, and it's our fault, and it's the church's fault, too," Swan says. "I'm driven by a sense of obligation to my son. I betrayed a child who was devoted to me and utterly dependent on me for his survival."
Since then, Rita Swan has given herself to fighting the so-called religious exemption laws -- a pivotal part of the Hermansons' defense. Child abuse laws in every state require parents to provide their children with food, clothing, shelter and health care. But in the mid-'70s, largely in response to Christian Science lobbying, a majority of states amended those laws to take religious beliefs into account. In the language of the Florida statute, "A parent or other person responsible for the child's welfare legitimately practicing his religious beliefs, who by reason thereof does not provide specified medical treatment for a child, may not be considered abusive or neglectful for that reason alone."
To the extent that the public is aware of this exemption, it is because Rita Swan has forced that recognition. From a small office in their home, she and her husband put out a newsletter on child neglect. She travels across the country to lobby state legislators, and she makes her argument on every television and radio program where she can wangle an appearance. She has come to Florida to see whether parents who relied on Christian Science healing to treat a sick child can be held legally responsible for the child's death.
Swan is hopeful the church might lose the Hermanson case. Amy was old enough when she fell ill that she had teachers, neighbors and others outside the family who could testify to the obvious severity of her condition. Child abuse was making front-page news, and prosecutors across the country seemed eager to take faith healers to court -- this was just the first of six cases pending against Christian Scientists.
But in its second week, the trial takes an unexpected turn. Booth announces that the defense will not call the Hermansons, or any Christian Science officials, to explain their beliefs. The judge reminds the jury that Christian Science is a well-established religion and warns that they "may not question the wisdom or the effectiveness of spiritual healing." The trial seems to be coming down to one narrow question: Were the Hermansons legitimately practicing their religion?
"Bill and Chris Hermanson did the best they knew how, consistent with their religious beliefs," Booth tells the jury. "You may not like it, you may not approve, but it was their way of caring for their daughter." Faith Healing or Child Abuse?
Christian Science has always been hard for outsiders to understand, and the defense was taking a gamble by leaving the jury to draw its own conclusions. Some of America's great satirists have derided the religion. H.L. Mencken dismissed it as "pure balderdash" and "quack healing." In the late 19th century, Mark Twain devoted a full book to deriding "the strange and frantic and incomprehensible and uninterpretable" tenets of the then-new faith.
Surely no religion ever had a more prosaic birth. As a Massachusetts newspaper reported one winter day in 1866, "Mrs. Mary Patterson of Swampscott fell upon the ice near the corner of Market and Oxford streets on Thursday evening." Mrs. Patterson, better known as Mary Baker Eddy after she took the name of her third husband, suffered a miscellany of injuries in her fall. Already a devotee of mental healing, she recovered by reading the Bible. In time, Mrs. Eddy developed her ideas on health and prayer into a full-fledged religion, with herself at the helm.
Every religion that worships an all-powerful, all-knowing God has had to come up with some way of accounting for the evil in the world. Christian Science may have chosen the most radical explanation of all. There is no evil in the world, no sin, no disease, no death. The argument is a simple exercise in logic -- this is, in part, the reason for the "Science" in Christian Science -- and it clicks shut with the finality of a proof in geometry: God is perfect, mankind is God's creation, therefore mankind is perfect.
Appearances to the contrary are exactly that -- appearances. Christian Science literature abounds with references to death and disease as mirages, illusions that can be overcome by realizing God's perfect nature. The theology stands conventional thinking about what is real on its head. "Man is not matter," declares Mary Baker Eddy in the church's official textbook. "He is not made of brain, blood, bones and other material elements."
It is almost impenetrable stuff, but Christian Scientists tend to justify their beliefs with personal accounts of their own healings instead of excursions into the murky waters of philosophy.
Christian Scientists use the term healings broadly. They tell of cures not only of life-threatening ailments but also of colds and hiccups; they learn to cope with athlete's foot and overbearing mothers-in-law. Even animals can be healed by prayer.
It is easy to dismiss these testimonies, or to wonder why Christian Scientists don't weed their literature and throw out those that deal with minor problems. But to split the testimonies into "serious" and "silly" is to misunderstand them.
The dramatic healings convey the message that prayer heals even life-threatening diseases. But the mundane ones have an equally important moral: Healings are not miracles, not once-in-a-blue-moon events in which the laws of nature are suspended, but an established and dependable part of the order of things. What's Really on Trial?
These beliefs are not on trial inside the courtroom, but they are being questioned outside it. Each time the Hermansons' trial recesses, Nathan Talbot, the church's national spokesman, finds himself surrounded by tape recorders and cameras and reporters asking why his church favors sitting back and watching children die.
"We agree with everyone else that the child comes first," says Talbot, a tall, neatly dressed and unfailingly pleasant man. "We feel just as strongly as the rest of society that you don't leave children untreated. The question is, what method of treatment is best?"
Questioning Christian Science because a child dies, Talbot argues, isn't fair. Just as the parents of children who die in hospitals somehow endure without abandoning their belief in medicine, so do devout Christian Scientists carry on. They might reproach themselves for not understanding spiritual healing well enough, but they aren't likely to turn from their faith.
To the bewilderment of outsiders, Christian Scientists seem to share an enviable calm. "Personally, I have not known a Scientist who did not seem serene, contented, unharassed," conceded Mark Twain, after satirizing the religion for 250 pages. Prosecutor Economou said, in astonishment, that Christine Hermanson wished him a cheerful "Good morning" every day, as he made his way into the courtroom to argue that she was a child abuser and a murderer.
Radiating reasonableness, Talbot describes the trial from the church's point of view. "The real issue," he says, "is that the prosecution wants the state to sanction one method of healing. But if people really are interested in saving kids, they'll want to look at the record."
Here he digs into his briefcase for a photocopied page of statistics. "We've done a study looking at the loss rate of all children between age four days and age 14. For the general public," he says, running his finger along the chart's top row, "the loss rate is about 51 children per 100,000. For Christian Scientists, the comparable figure is 23 per 100,000."
He puts the page aside for a moment. "Why would the public want to force on us a method of healing that's not as successful as our method?"
Norman Fost, a doctor and chairman of the American Academy of Pediatrics Committee on Bioethics, has spent a lot of time trying to answer that question for Talbot. "I don't doubt those figures are true," Fost says, "because Christian Scientists tend to be well-to-do people. Their death rates should be lower than for the general population. The question is, what are their mortality rates for the diseases in which they're accused of being negligent, like diabetes and meningitis?"
Fost pauses, knowing full well that the controlled study that would answer his question will never be done. The Christian Science church uses statistics only selectively. A bylaw even forbids the church to count how many members it has; current estimates range from 100,000 to 200,000. And it rejects all suggestions to compare, for example, 10 children whose bacterial meningitis was treated with antibiotics with 10 children whose meningitis was treated with prayer.
Once or twice, Christian Science has been put to the test by happenstance. In 1985, measles broke out at Principia College, a Christian Science school in Illinois. Few of the 700 students had been immunized. About 120 people fell ill, and three died. That death rate is more than 20 times higher than the death rate from measles in the general population.
Last September, the Journal of the American Medical Association published a statistical study comparing the longevity of Principia graduates with a control group. After analyzing 50 years of alumni records, the researcher found that both men and women graduates had significantly higher death rates than their counterparts in the control group. The finding is especially surprising considering that Christian Scientists don't smoke or drink.
Talbot's evidence is of a different sort. He waves a sheaf of papers and rattles off a kind of Twelve Days of Christmas litany of cures: "Twenty-seven malignant cancers, 16 cases of polio, 68 of tuberculosis, 203 broken bones, eight cases of acute appendicitis, seven of blindness." The tallies include children as well as adults. "Children are so responsive to our methods," says Talbot, "that I think most Christian Scientists would say they are more quickly and effectively healed than adults are." Of course, whether the supposed cure involves adults or children, follow-up is next to impossible. Most Christian Scientists never see doctors for diagnosis. If medical records do exist, they are usually unavailable -- the church says it doesn't want to embarrass doctors by linking their names with spiritual healing.
"The vast majority of health problems that Americans have are things that technology cannot help, and for which positive thinking and prayer and staying away from health care is not a bad idea," says Fost of the pediatrics academy. That was all the more true when Christian Science was born, in 1879. Medical care was then so rudimentary that Mary Baker Eddy may have performed a service by keeping people away from doctors.
In any case, Christian Scientists don't do without doctors altogether. While they believe that conventional medicine, with its earthbound focus on disease, reinforces illness, the decision to abandon spiritual healing and seek a doctor's advice is always up to the individual. And there are many routine exceptions to the general rule: It's customary to see a dentist, for example, and to have broken bones set. Eyeglasses, hearing aids and crutches are fine, presumably because they are simply aids rather than cures. And Christian Scientists have used obstetricians ever since a notorious case in 1888, when a woman giving birth was attended only by a Christian Science practitioner and both mother and baby died.
The Hermansons' prosecutor wants the jury to think hard about these exceptions. The Hour of Judgment
Economou calls Christian Science nurse Mary Jane Sellers to the stand. Sellers was brought in to help care for Amy in her last hours, but by the time she arrived at the Hermansons, Sellers testifies, Amy was unable to hear or speak. Sellers told the Christian Science practitioner already in attendance that Amy needed more help than she could provide. "I said, 'Do you mind, I think I should be calling an ambulance,' and he said, 'Okay.' It was okay for me to do so."
"She kept her eyes closed the whole time," Sellers said in an investigation before the trial. "She had beautiful skin and long black lashes, and it wasn't the easiest thing, watching a little girl like that." Amy was dead when the paramedics arrived.
The prosecution's blockbuster witness is a friend of the Hermansons named Mary Christman. She had visited with Chris Hermanson three days after Amy died. The prosecutor asks whether the two friends had happened to discuss the Hermansons' own medical histories. "Yes, I did," Christman says. "I told her, 'God, Chris, if Bill had novocaine and you had two Caesarean sections . . .?' "
But the jury never hears any of Christman's testimony. They've been sent out of the courtroom until a ruling is made on whether the new information is admissible, and because of a prosecution blunder -- Economou has neglected to inform the defense ahead of time about the new evidence -- the judge rules it out.
Things seem to be running in the Hermansons' favor. The jury seems caught up in their lawyer's long closing argument, delivered with the fervor and volume of a Fourth of July oration. "Is it fair under our system of justice to brand this mother and father as murderers because they put their faith in God instead of a doctor?" Edward Booth demands. "Is it fair when the law in Florida says if you do that, there's an exemption and you're not going to be subject to prosecution?"
The prosecutor is as subdued as the defense is flamboyant. Forsaking the lectern that Booth used as a pulpit, Deno Economou stands directly in front of the jurors, motionless, almost close enough to touch them if he were to stretch out his arms. In a voice just above a whisper, and occasionally inaudible to the spectators only several yards away, he makes a simple argument.
"No one of us has the right to question another person's religious beliefs," Economou says. "We all recognize that. The key issue in this case is the legitimate practice of those beliefs. If the defendants wish to become martyrs for their religious beliefs, they have that right. They do not have the right to make a martyr of their 7-year-old child."
When the judge poses his final instructions to the jury, he seems to favor the Hermansons. "You are not to decide if the defendants correctly interpreted the teachings of their religion," he tells the jury, "only whether the defendants held a sincere belief that the teachings of their religion authorized them to take a particular course of action."
The smart money figures that the Hermansons are as good as free. What clearer proof of their sincerity could there be than they lost their daughter for their beliefs?
As the jury files out, Swan tries to prepare herself for what she sees as an inevitable acquittal. "It's farcical to give this case to a jury with those instructions," she says. "The case should have been thrown out a year ago if the only question was if they were sincere about their religion."
After only three hours, the jury returns. They needed to vote just once and were unanimous from the start: The Hermansons are guilty.
"I don't like to see anybody get hurt," one juror says to a local reporter, referring to the Hermansons. "But somebody already did, didn't they?"
Two months later, the judge hands down his sentence. Although Florida guidelines recommend a prison term of three to seven years for third-degree murder and child abuse, he gives the Hermansons suspended sentences of four years and places them on 15 years' probation, with the stipulation that they take their two sons to doctors for regular checkups. That is nearly identical to a sentence imposed in July by a Massachusetts judge on David and Ginger Twitchell.
It is a case with only a brief epilogue. Bill and Chris Hermanson are appealing their convictions; a hearing on the appeal was held this month, but the Florida Court of Appeals has not issued its ruling yet. The couples say their faith is stronger than ever. Rita Swan continues to fight to repeal the religious exemption laws. And Amy Hermanson is dead.
Edward Dolnick is a contributing editor of In Health magazine, from which this article was excerpted. Copyright 1989. Hippocrates Partners.