Playing Sick?: Untangling the Web of Munchausen Syndrome, Munchausen by Proxy, Malingering, and Factitious Disorder by Marc D. Feldman

Author:Marc D. Feldman [Feldman, Marc D.]
Language: eng
Format: epub
ISBN: 9781136748837
Publisher: Taylor and Francis
Published: 2004-06-03T00:00:00+00:00

Katie’s Drama

Seven-year-old Katie was victimized by her mother for six years. During five of those years, the child was seen 126 times at different clinics and by a private physician and was treated for several disorders, including a condition that required pressure equalization tubes to be placed in her ears. The fever of unknown origin (FUO) that finally led to the discovery that her disorders were false began when she was only one year old. The FUO supposedly continued as the child grew, but each time she was admitted to a hospital, her temperature would quickly return to normal. Tests that included cultures of blood, urine, stool, and spinal fluid were always negative.

At the age of four, based on the medical history supplied by her mother, Katie was put on medications for asthma and allergies. By the age of six, she was receiving five asthma medications that had been prescribed by her primary care physician, and her diet was limited to ten “safe” foods. Despite the way the child was being forced to exist, she had shown no signs of wheezing, and skin tests for inhalant allergens were normal.

This girl lived with her mother, stepfather, stepbrother, and stepsister. Her stepfather was a blue-collar worker and her mother was an emergency medical technician. The child was supposedly so ill that she couldn’t attend school and had at-home tutors. At one point, she developed severe diarrhea and vomiting requiring administration of intravenous fluids. She then displayed the symptoms of an overdose of the asthma medication theophylline. Her mother, who had refused to relinquish an active role in monitoring the child’s vital signs and administering her medication, denied playing a role in this latest medical dilemma. However, the baffling constellation of physical problems, which came and went, and the onset of theophylline poisoning finally alerted doctors to the likelihood of MBP.

They admitted Katie to a pediatric intensive care unit and notified her stepfather, Children’s Protective Services, legal counsel, and her primary care physician. It was discovered that the mother had a chronic history of abuse as a child, and also as an adult at the hands of her first husband. An investigation concluded that she had indeed induced the child’s frightening medical signs and symptoms. By devoting her life to “helping” her “sick” child, she could, in the eyes of the world, be a nurturing, martyr-like mother, unlike her own abusive mother.

After a court arranged alternate care for Katie, the child thrived without medications and was able to attend school regularly.

“We may teach, and I believe should teach, that mothers are always right,” Dr. Meadow once wrote, “but at the same time, we must recognize that when mothers are wrong they can be terribly wrong.” Dr. Meadow warns that the realization that a child is a victim of MBP evolves slowly. The point at which intervention should occur, he says, depends on the amount of proof a doctor is able to accumulate and the level of danger faced by the child.

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