PHILLY
EVENTSThe Noes were led to believe that any suspicions about them disappeared when they passed the polygraphs. “We had the lie detector test, they let us go home, and that’s all we ever heard from them,” Mr. Noe recalls.
Neither the Noes nor the public ever learned medical examiner Joseph Spelman’s true feelings about the case. But buried in the autopsy files of Arthur Noe are two identical letters that make the opinions of the late pathologist crystal-clear. One is addressed to the city office overseeing adoptions, foster home placements and child protection services, the other to the corresponding state agency. Both were written in response to comments Mrs. Noe made to investigators McGillen and Bristow at the funeral home during Little Arty’s viewing. When asked how she intended to occupy her time, Mrs. Noe said she would still like to adopt a baby or take in a foster child.
Spelman’s letters read:
”You undoubtedly have read about the death of the tenth child in [the Noe] family. … This office has actively investigated several of these deaths. We have extensive files on the background of this family. We are not willing to declare with certainty that these children died natural deaths.
”In the event that thought is given to placing children under the care of the Noes, we would be glad to discuss our file and our thoughts in detail.”
Yet when Spelman had the opportunity to list a cause of death that was more likely to provoke continued investigation, he didn’t. If the cause of death had read, for example, “undetermined, consistent with suffocation,” both the media and the police might have been encouraged to pursue the case further. But by that time, Spelman may not have had enough political clout left to take such a bold public stance against a publicly sympathetic mother. Fillinger points out that the medical examiner had successfully battled a well-known drinking problem, and that his chief pathologist, the outspoken Dr. Joseph Campbell, had barely survived an attempt to fire him over his erroneous testimony in a case. In the months after the last baby died, Spelman may also have been distracted: He was designing the new morgue (still in use today), he was called to testify in the autopsy of Mary Jo Kopechne, who had drowned in Senator Ted Kennedy’s car, and then Campbell, his second-in-command, was diagnosed with terminal lung cancer. Campbell died in 1969, at the age of 44. Spelman died two years later.
During his lifetime, Spelman’s true feelings on the Noe case were voiced only once — not by him, but by Molly Dapena, in front of two dozen infant mortality experts who had gathered on a remote island in Puget Sound to decide the future of research on sudden infant death. (It was at this 1969 conference that “crib death” was officially renamed SIDS.) After a presentation, a doctor asked about the public perception that SIDS “runs in families,” a misperception popularized by coverage of that “family in Philadelphia” in the lay press.
”I’m familiar with that particular family,” Dapena announced. “Dr. Joseph Spelman, the chief medical examiner of the city of Philadelphia, has concluded that these children did not die of SIDS. However, because of legal implications, we are not at liberty to report the results of his investigation.”
There is no record of the case ever being discussed publicly again until 1997, when the Noes were mentioned by pseudonym in The Death of Innocents.
Retired homicide detective Joseph Schimpf, now 77 and slowly recovering from two open-heart surgeries in a small town in Tennessee, doesn’t see why the Noe case should be brought up again. He stands by his 1968 conclusions. “It’s still the same old case,” he says, gasping for breath between phrases. “The guy in the coroner’s office [McGillen] still thinks the lady is responsible, and I still don’t. I didn’t see no kind of evidence. [Mrs. Noe] was supposed to be kind of slow, not ‘with it,’ so I don’t see how she could have fooled all these more intelligent people. …I don’t think she was bright enough to kill everybody and nobody knew how she did it. … There was a possibility they were involved in two or three of the cases. …I guess I’m just of the opinion that there’s something screwy but she’s not guilty.”
Molly Dapena feels differently. “It is truly incredible to me that nothing was done,” she says. “And one wonders why, since Dr. Spelman thought it was murder back then.”
Yet when some of Dapena’s colleagues are told that one of the main reasons the Noe case is being reinvestigated is because she boldly spoke out — first to the authors of The Death of Innocents and later to me — they are flabbergasted. They recall Molly Dapena in the ‘60s and ‘70s as a prominent voice shouting down the idea that a mother could kill her children.
Besides her teaching and autopsy work, Dapena was, in those days, the great debunker of theories about crib death. Using the files of the Philadelphia OME as a database, she wrote authoritative papers in top journals disproving that SIDS was linked to viruses, to parathyroid abnormalities, to changes in the conduction system of the heart or to retention of something called “brown fat.” But as a mother of 11 children herself and a stickler for a purely scientific interpretation of autopsy rules — at a time when public health officials were beginning to improvise in order to address the growing problem of child abuse — she developed a reputation for having a maternal blind spot. Dr. Dimitri Contostavlos, a former Philadelphia assistant M.E. who is now the Delaware County medical examiner, says,”She and her gang had a sort of ‘no-mother-can-do-any-harm’ philosophy.” He remembers her as being too focused on the strictest possible interpretation of the physical autopsy results and not willing enough to consider the circumstances surrounding a child’s death. He remains annoyed that when the city prosecuted a mother in 1971 who admitted smothering three children whose deaths were previously attributed to SIDS, Dapena testified for the defense about the righteousness of the “undetermined” causes of death.
Fillinger also recalls, “Molly testified a lot for the defense in child-abuse cases, and felt inclined as a mother to see the mother’s side of it. We were more prosecutorially oriented. But she was such a sweet girl, and she knew so much that you readily forgave her any tenderness of heart that might make her see the side of a parent in a sympathetic light.”
After being told what her colleagues said, Dapena thinks for a moment. “Well, I don’t remember being terribly upset at the time that [Mrs. Noe] was a mother who was murdering her children,” she says, literal-minded as always. “But I think that’s because I was an innocent in this regard. The person who became suspicious was Spelman. He was more wise about this. I was an innocent.”
She was also an innocent about the theory that SIDS was caused by sleep apnea and could be prevented by monitors, which she “bought hook, line and sinker” at the time. It became a theory SIDS mothers embraced, using it against researchers who suggested that a small percentage of the deaths might be infanticides and who sought to explore the psychodynamics of child murder. New York psychiatrist Stuart Asch was among the first to try to get pathologists interested in the subject. While studying crib death for the New York City medical examiner in the ‘60s, Asch developed a theory that individual child murders are often committed by mothers suffering from severe postpartum depression — almost a form of suicidality that can be treated and rarely occurs — but that serial cases are something else entirely. “These mothers are infantile, self-involved, narcissistic and probably simple schizophrenics,” he declares. “To them, the baby is not seen as a person. These women seem almost autistic in that way, because they have no feeling for the baby, don’t understand what the baby is doing. The reason for killing the baby is probably [that] she wants a relationship, she wants people to pity her.” Asch recalls lecturing about his theories at a psychiatric conference in the early ‘70s and getting an earful from audience member Molly Dapena, who “said she doesn’t believe crib deaths are murder.”
In 1977, a new diagnosis called Munchausen syndrome by proxy appeared in the literature. In the most common manifestation of this bizarre pathology, a mother either fakes or deliberately causes a child’s recurring illness in order to create increasingly intertwined relationships with doctors and nurses. Munchausen mothers typically suffocate or poison their babies. While Munchausen by proxy would become a catch-all diagnosis for serial SIDS cases, Dr. Stephen Ludwig, longtime child abuse expert at Children’s Hospital of Philadelphia, believes the Noe case could be even more complex. The Munchausen mothers he has known showed no other signs of mental illness, were extremely intelligent, and were always attentive to their children in the hospital. It was also clear what they hoped to gain from their behavior: multiple hospitalizations that brought attention from doctors, not necessarily the deaths of their children. Ludwig wonders what else the Noes might have had to gain from the deaths, noting that he has seen Munchausen families who got the attention they craved from the press. Ludwig also wonders if these acts could have been carried out in a dissociative state, a separate consciousness, so Mrs. Noe wasn’t really cognizant of what she was doing and later couldn’t remember what she had done. A noted psychiatrist suggests that the first Noe child might have died from natural causes, and the subsequent near-misses and deaths could have been caused by Mrs. Noe reenacting the loss in a dissociative state.
Ludwig recalls that in the early ‘70s, city agencies and hospitals weren’t prepared to deal with “even straightforward cases of child abuse,” so he’s not surprised a case as tangled as this one was dropped. But he believes this level of mental illness could still be diagnosed today by a good forensic psychiatrist. “A thorough investigation is not only warranted, but these children demand it,” he says.
But by the time these kinds of ideas were coming to the forefront, Molly Dapena had left Philadelphia and the OME. Her husband insisted on moving the family to Florida, so Dapena and the five children they still had living at home joined him there, and she took a position at the University of Miami Medical School. Her husband soon left her to marry another woman, and then suffered a stroke during his honeymoon in Paris, rendering him a near-invalid. Dapena not only supported her children, she also helped her ex-husband’s new wife take care of him until he died in 1985. She went on to become lead author of the National Institute of Child Health and Human Development’s authoritative 1993 text on SIDS.
Molly Dapena hadn’t thought about the Noe case for years until approached by the authors of The Death of Innocents in 1995. I ask her if she feels that by helping the authors of the book, and now by speaking out more publicly about the Noes, she has redeemed past oversights.
”That had nothing to do with it,” she insists. “I don’t think I was trying to redeem myself. I was just trying to be helpful to people working on a project. If I can help people, I’ll do what I can.”
Is it possible that the result of your actions is to redeem yourself, as some of your colleagues have suggested?
”Well, I would rather trust their memories than mine,” she says.
Regardless of age-old sins of omission or commission, what was true then is true now. The status of the Noe case is likely to be changed only with a confession. There was no definitive physical evidence then, and there is little hope the bodies of the Noe children would yield any more useful information today. Several are buried in a Philadelphia cemetery that was somewhat notorious in the medical examiner’s office. After a hard rain, it wasn’t uncommon for the M.E. to receive a call about bodies washing up from their graves.
Once more, a sense of dread has returned to the Noe home. Following the death of their 10th child, the couple’s attempt to get on with their lives met with some relative success. After years of working in factories and serving as a local committeeman on the side, Mr. Noe was able to get a string of low-level political patronage jobs with the city. (He was an aide to Harry Jannotti, until the councilman was brought down by Abscam.) Marie, whose migraines disappeared after her hysterectomy, became a local committeewoman, and Art was able to help her get jobs at traffic court and the parking authority. They became more active in the church, and by their own admission grew much closer than they had been while having children.
But that life phase has ended as well. They are “in dire straits.” In one of our conversations, Mr. Noe says he has had a premonition he will die soon, eliciting a nervous laugh from Mrs. Noe. In a later discussion, Mr. Noe tells me he is thinking of killing himself. “My life’s been screwed up,” he says. “What the hell?”
The Noes recall feeling resignation when they were investigated 30 years ago. “No matter who dies or how they die, there’s always an investigation,” Mr. Noe says. “What can you say — ‘Stop, I don’t want you to’? The law states the coroner has the right to investigate. They come to the door and ask questions.
”That’s how I felt then. I can’t say what I’m gonna feel now. Ah, the hell with you. It’s over with. Let them think what they want.”
”People are gonna think what they think,” his wife agrees. “Sometimes you’d like to hide under a log, but what good is it gonna do? I know I often question myself about each one of them babies. … you feel it’s your fault, and you coulda prevented it because you were so tied up in yourself or something.” She rubs the back of her hand across her misty eyes. “I imagine every person that has a SIDS case thinks this way — “
Art interrupts. “You’re not responsible Marie,” he says. “It’s just something that happened.”
The last time I visit the Noes, the reality that their case is being reinvestigated has finally sunk in. Mr. Noe paces back and forth on one side of the dining room, punctuating his bitter monologue by pointing his cigarette, while Mrs. Noe stands perfectly still on the other side, interjecting a thought only when her husband pauses to take another drag. “If I killed them babies,” she says, “do you think we’d still be living in this same neighborhood, and have all these pictures of them up?”
Mr. Noe says he wants to know — if people are so goddamn interested in new theories about his dead babies, “What about killer genes, huh?”
Listening to this gaunt, haunted couple, I think about what Fillinger told the nun about the Noes over 30 years ago — that they have either endured one of the most horrific medical tragedies of the century, or they caused it. Watching the two of them brings to mind one of those winking Jesus postcards. As they rail at me, I move my head slightly, and the picture changes. From one angle they look like a sad old couple falsely accused, from another a sad old couple falsely exonerated. Mr. Noe is either a husband fiercely protecting his wife or a desperate man protecting himself.
From every perspective, they are sick with fear. They jump when there’s a sound from the street or a knock at the door. Sometimes it’s a neighbor, out of rehab, asking for a few bucks — nearly broke themselves, the Noes are still a soft touch — and sometimes it’s just the local free shopper being lobbed from a slow-moving delivery car. But one day soon, it will be a homicide detective knocking on their door. If he arrives before death does, they will have some explaining to do.
