The Preventionist – Episode 2: The CAP Will See You Now
Date: October 30, 2025
Podcast: The Preventionist (Serial Productions & The New York Times)
Host/Reporter: Dyan Neary

Episode Overview

In this gripping episode, reporter Dyan Neary investigates the career and influence of Dr. Deborah Asernio Jensen, a pediatrician whose zeal for diagnosing child abuse has left a trail of controversy across multiple states. Neary delves into how Dr. Jensen’s actions—and the rise of the new medical specialty of child abuse pediatrics (CAP)—have led to families being wrongfully separated, and how challenging these diagnoses can be nearly impossible. Through court records, interviews, and personal stories, the episode offers a profound look at the perils and powers of CAPs and the unintended consequences affecting families.

Key Discussion Points & Insights

Community Outcry and Dr. Jensen’s Reputation

• Families in Lehigh County, Pennsylvania, publicly accused Dr. Jensen of repeatedly making false allegations of abuse, resulting in the forced separation of children from their parents.
• At a local public meeting, Dr. Jensen’s name was mentioned 108 times ([01:21]) as parents pleaded for her removal and for systemic reform.
  • Quote: “Get rid of Dr. Jensen and fix the system because it’s broken.” – Unnamed parent ([01:10])

Dr. Jensen’s Career and the Rise of Child Abuse Pediatrics

• Dr. Jensen began focusing on child abuse pediatrics in New York City in the tense aftermath of the notorious Elisa Isquierdo case (1995), which led the city to adopt a “better safe than sorry” approach to child protection ([03:33]).
• Dr. Jensen, originally reluctant, was encouraged into the field, quickly developing a reputation among colleagues for being unusually aggressive in diagnosing abuse:
  • Quote (Dr. Jensen): “I can’t say I enjoy child abuse. Of course, no one enjoys child abuse… but basically what I’m saying, it’s never boring.” ([05:08])
• Multiple lawsuits and judicial opinions from her New York years claimed Dr. Jensen misdiagnosed cases, often rejecting alternative explanations offered by other experts ([08:14]).

Judicial Scrutiny and Professional Critiques

• Judges in New York family court found Dr. Jensen “argumentative and defensive,” “unreasonably judgmental,” and less knowledgeable than other specialists ([09:55]).
• Dr. Ram Khairam, a pediatric neurologist, reflected:
  • Quote: “She was confident of her judgment… she did not know how much science she did not know.” ([11:58])
• Attorney David Lanzner surmised that judges went into unusual detail in their opinions “because they wanted to warn other judges about Dr. Jensen.” ([12:18])

The Power of the CAP Diagnosis & Florida Cases

• With the creation of the CAP subspecialty, Dr. Jensen’s role became more authoritative, moving from being one voice among many to the decisive medical authority in suspected abuse cases ([13:00]).
• Case Study: Jesse Santiago (Gainesville, FL, 2011)
  Dr. Jensen diagnosed abuse in a case where other medical opinions conflicted. The diagnosis led to Jesse’s children being removed; he later lost his parental rights and faced criminal charges that were ultimately dropped.
  • Quote (Jesse): “We didn’t know it was going to be for good.” ([19:56])
    Multiple outside experts later determined the case was “as gray as it can be” and that Dr. Jensen’s certainty was unsupported by the medical literature ([16:57]).
  • Quote (Forensic pathologist): “This was in no way a clear cut case of abusive head trauma.” ([17:50])

Divisions Within the Field of CAPs and the Broader Child Welfare System

• Dr. Randall Alexander, Dr. Jensen’s supervisor, defended her, stating:
  • Quote: “I couldn't find anything. She did great work... I never had that case [where I disagreed].” ([24:40])
• Dr. Alexander downplayed complaints against CAPs as an occupational hazard, given the adversarial role they inhabit ([26:08]).
• He also championed a controversial statistic, claiming 40% of the population experienced child abuse—a figure Neary notes is an overstatement (the actual number for physical abuse is closer to 18%) ([28:16]).

The Difficult “Gray Areas” and Systemic Bias

• Neary highlights that advances in medical science have shown that many injuries previously considered definitive for abuse can occur accidentally, and that some CAPs fail to reckon with this evolving science, leading to overdiagnosis ([30:14]).
• Systemic bias is noted: misdiagnoses most often impact poor families and families of color.
• Several current CAPs caution against a “cowboy” approach in the field, emphasizing the importance of scientific humility and interdisciplinary checks.

The Illusion of Checks and Balances

• Officially, CAPs are one part of a multidisciplinary process, but in practice, their word often becomes the final say—even overruling caseworkers and families ([31:49]).
• Case Study: The Football Player & Munchausen by Proxy Diagnosis (Gainesville, FL, ~2012)
  • Child Protective Investigator Andrew Caswell challenged Dr. Jensen’s finding of Munchausen by proxy; his supervisor removed him from the case when he refused to verify abuse ([35:51]).
  • Quote (Caswell): “It was as if I had no involvement... what I had to say didn’t matter. They think that she’s a doctor and she knows what she’s talking about.” ([40:06])
• Multiple caseworkers and supervisors reported frustration at not being listened to and feeling “terrorized” by the hospital child protection team ([42:06]).

Higher-Level Resistance and Systemic Tension

• Supervisors and prosecutors in Florida recall “tumultuous” years under Dr. Jensen, with many decisions being challenged or blocked at higher levels:
  • Quote (David Abramowitz, regional DCF director): “Every week someone’s calling me up, sir, she wants to remove this kid... I’d go, don’t remove them.” ([44:21])
  • Quote (Bill Servone, local prosecutor): “She and her agency took a very aggressive stance on all cases and that they should go forward… contrary to what we believed the evidence allowed us to prove.” ([45:29])
• Dr. Jensen was eventually removed from her post in Gainesville after a complaint (the IG found no wrongdoing), but she soon found a new appointment in Pennsylvania ([46:26]).

New Laws in Pennsylvania & Continuing Controversy

• Dr. Jensen arrived in Pennsylvania amid a climate shaped by the Jerry Sandusky scandal and legislative reforms that greatly expanded mandatory reporting of child abuse ([47:07]).
• As the first CAP at Lehigh Valley Child Advocacy Center, her tenure resulted in a spike in Munchausen diagnoses and family separations, culminating in at least 27 lawsuits against her and the hospital ([47:41]).

Notable Quotes & Memorable Moments

• “Get rid of Dr. Jensen and fix the system because it’s broken.” – Parent testimony ([01:10])
• “She found child abuse where no other doctor found it, and she went way beyond what other doctors did.” – David Lanzner, family law attorney ([07:47])
• “She was confident of her judgment... she did not know how much science she did not know.” – Dr. Ram Khairam, neurologist ([11:58])
• “I couldn’t, for the life in me, figure out where she saw abuse.” – Andrew Caswell, child protective investigator ([35:59])
• “It was as if I had no involvement in the case... what I had to say didn’t matter.” – Andrew Caswell ([40:06])
• “She and her agency took a very aggressive stance on all cases and that they should go forward… contrary to what we believed the evidence allowed us to prove.” – Bill Servone, prosecutor ([45:29])
• “I was so busy with her kids... Jacksonville, never a problem. Daytona, same thing… Her, I was just…” – David Abramowitz, DCF regional director ([44:21])
• “Child abuse is 40% or so… Of the general population.” – Dr. Randall Alexander ([27:57]) (disputed claim)

Important Timestamps

• [01:21] – Dr. Jensen’s name recited 108 times in public testimony
• [03:33] – Background: Elisa Isquierdo case, context for CAP rise
• [08:14] – Attorney and judge critiques of Dr. Jensen’s expertise
• [11:58] – Dr. Kairam reflects on the limits of Dr. Jensen’s knowledge
• [14:23] – Jesse Santiago's family enters the child protection system in Florida
• [19:35] – Jesse is asked to relinquish parental rights; impact on his life
• [24:40] – Dr. Alexander’s defense of Dr. Jensen
• [26:08] – Dr. Alexander on why CAPs receive so many complaints
• [28:16] – Fact-checking the 40% child abuse prevalence statistic
• [35:51] – Andrew Caswell, caseworker, challenges Dr. Jensen’s diagnosis
• [40:06] – Caswell on his feeling of being overruled
• [44:21] – DCF supervisor describes outsized impact of Dr. Jensen
• [45:29] – Prosecutor on Dr. Jensen’s aggressive approach
• [47:41] – Pennsylvania reforms and lawsuits against Dr. Jensen

Tone and Takeaways

The tone is investigative, meticulous, sometimes emotional and frequently critical of the unchecked power that CAPs like Dr. Jensen can wield. Dyan Neary threads firsthand stories, expert commentary, and documentary evidence to expose gaps in oversight—while acknowledging the lifesaving importance of the field at its best.

Conclusion

This episode illuminates the emergence of child abuse pediatrics as an influential and controversial subspecialty—with Dr. Jensen as a prime example of both its necessity and its dangers. Through powerful testimony and documented cases, Neary shows that while child protection is paramount, the system as it stands too often leads to tragic errors, questionable diagnoses, and irreparable harm to families—with insufficient mechanisms for accountability or redress.

For more analysis and ongoing coverage, listener Q&A, and updates on the Pennsylvania lawsuits, subscribe to The Preventionist newsletter at nytimes.com/serialnewsletter.