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When You Suspect The Worst

Apr09

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I have a really complicated question, culminating in a “OMG what do I do?”

A friend of more than a decade has suffered from multiple health issues and allergies onset in her adulthood, most of them pretty rare, and took months and years to get diagnoses and treatment, and some she’s never received a diagnosis or treatment.

Recently, her tween daughter has been suffering from strange symptoms, including vomiting, rashes, nausea, and a number of things that appeared to be allergy-related, but maybe not because my friend tried eliminating the possible allergen but there’s still vomiting or bloating or headaches or whatever. This has been going on for months and months, with little relief, and a confusing array of symptoms and causes.

I am honestly very reluctant to even say this, because I don’t want to place doubt on anyone’s health issues, but I’m beginning to suspect Munchausen’s by Proxy Syndrome. I realize that as a complete medical outsider it’s a pretty serious claim, but everything just seems suspicious.

The symptoms came on suddenly, but are very sporadic, And according to my friend don’t seem to have any connection to one another, despite many, many months of sickness.

My friend has suffered from multiple, obscure allergies, and is now under treatment, so isn’t suffering herself as much as she was. When she was suffering, I (and other friends) heard about it regularly. Now, we hear about her daughter’s issues, and occasionally about her own.

They just moved to a new location, have few friends there, and the symptoms are most prevalent when the father is out of town, which is weekly.

My friend gets upset when doctors are “dismissive,” saying that it may be a virus and to ride it out, and tends to insist on more and more invasive tests and procedures, getting upset if the doctors can’t or won’t identify more tests.

I’m really torn. On the one hand, if it were my daughter and she were really suffering from something like this, I’d be beside myself trying to get appropriate treatment. On the other hand, it seems suspect to me that there are so many disparate, severe, untreatable symptoms that suddenly popped up when she started receiving treatment for her own symptoms.

So, should I feel responsible to talk to someone about this? Should I talk to my friend? Or a doctor? I’m so concerned about this, because I’m so afraid for the little girl’s health (omg, she was so tiny and shy and underweight to being with), but don’t want to overreact. They’re in a different state so I don’t know where I’d go.

Am I being a buttinsky?

Truly Concerned Friend

Reading this letter gave me actual, honest-to-God chills. CHILLS. I was thinking the same thing — the M by P thing — before you even typed it out. Something about this situation sounds…off. Not quite right. And since you’ve been friends with this woman for more than a decade, I’m guessing you’re not coming up with unfounded suspicious way out of left field.

Please please please call the National Child Abuse Helpline IMMEDIATELY and tell them about this little girl and your fears for her health and safety. The number is 1-800-4-A-CHILD. (1-800-422-4453). You can make the call anonymously. You can also call her state’s Child Protective Services directly — most states have toll-free numbers and allow you to remain anonymous as well. Here’s a list of websites and numbers for reporting your suspicions.

You’ve mentioned SO MANY classic red flags here — the symptoms appearing while her husband is away, the anger at medical professionals, the demands for invasive procedures, her fixation on the illnesses, etc. — that one would hope the doctors would be “onto” her already, but since she has years of “practice” with her own ongoing Mysterious Illnesses of Mystery, it’s entirely likely that she’s a skilled pro at faking/malingering and knows to doctor-hop before anyone gets too suspicious.

Yes, Muchausen By Proxy is a very serious claim and one that feels doubly cruel to make against someone who may actually be dealing with a genuinely sick kid. But given the facts as you have typed them, I’m very worried about this child too. (Anyone been around the mommyblogging world long enough to remember The McDonald Five nightmare from a few years ago? OMG.) It’s a difficult thing to “prove,” but the discovery of the (often life-threatening, sometimes fatal) abuse always starts with the same thing: Someone suspecting that something is not quite right, and acting on that small, nagging suspicion.

Someone needs to step in and at least raise the possibility that her mother is making her sick. And as upsetting as the situation is, SOMEONE NEEDS TO BE THAT SOMEONE. You can be that someone. 1-800-4-A-CHILD.

Photo source: iStockphoto/Thinkstock

About the author

Amalah

http://www.amalah.com
Amalah is a pseudonym of Amy Corbett Storch. She is the author of the Advice Smackdown and Bounce Back. You can follow Amy's daily mothering adventures at Amalah. Also, it's pronounced AIM-ah-lah.

If there is a question you would like answered on the Advice Smackdown, please submit it to amyadvice@gmail.com.

Amy also documented her second pregnancy (with Ezra) in our wildly popular Weekly Pregnancy Calendar, Zero to Forty.

Amy is mother to rising first-grader Noah, preschooler Ezra, and toddler Ike.


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19 Responses to “When You Suspect The Worst”

  1. Cristin Apr 09 at 2:48 pm Reply Reply

    I have no other advice. Amalah’s spot on once again. Imagine if something more serious happened to this child. I would definitely tip off the hospital to put cameras in her room, should she ever be admitted. 
    M by P is very real to me. My husband’s ex wife started to show signs of it and had THOUSANDS of dollars worth of asthma meds for their youngest son, who lives with us now and does not have asthma. ER visits, specialists, etc. She even pushed the child’s teachers and school psychologists to have him labeled as autistic.  Thank God she came to her senses and gave custody to their father. Now she’s the one going to ER’s, being “sick.” 
    This girl needs an advocate and you may be that person. Best of luck. 

  2. A Apr 09 at 3:11 pm Reply Reply

    TRUST YOUR GUT!!! Amalah is correct. Report it. Do not pass go. Do not collect $200.

    I don’t have any experience with M by P but I have seen kids getting abused and not understood what was going on at first. After years of “odd” and “off” behavior by my husband’s young cousins and witnessing the bizarre actions and words of their mother I secretly met with their father and voiced my concerns. He told me some horrifying things. What were major red flags to me passed him by unnoticed (like that the kids were starting to torture their cat). My butting in caused a big ruckus at the time but when the mother passed away 6 months later the relief on those little boys’ faces was crystal clear. In the months and years that have gone by they have mature into great kids. I don’t know what their mother was doing to them but I’ve never seen kids bloom and thrive in the wake of their mother’s death before. I wish I had said something much sooner.

  3. Cheryl S. Apr 09 at 3:14 pm Reply Reply

    I agree with Amy. Someone has to do something. There was a horrible case here in Florida. The girl was subjected to surgeries, multiple hospitalizations, feeding tube because she “couldn’t eat” etc. Within a week of being removed from her mother’s care she was eating snickers bars and off all medications. Please, find a way to alert someone. Also, the little girl could also be acting out since that is the way she can get her mother’s attention. Either way, someone needs to look into it.

  4. Rachel Apr 09 at 3:37 pm Reply Reply

    I totally agree with Amy, here. I am not a doctor, but my dad is a pediatrician, and he has some horrifying stories of what some parents do — including one putting actual KETCHUP in a toilet and claiming it was blood (??) and then flat-out denying it when caught (because…hello, it was ketch-up). As a pediatrician, you rely on parents a lot (especially with young children who can’t talk/give symptoms themselves) and so even when you suspect, there’s not always a lot you can do, so, yes yes yes…call the hotline, try to help as much as you can!

  5. Holly Apr 09 at 4:16 pm Reply Reply

    Additionally, if she’s roving around to multiple doctors and hospitals, that is also a sign pointing toward M by P. MDs have so many patients, and unless it’s the same – say, Primary Care Physician, that she’s ALWAYS nagging/seeing, my guess is that it is not raising red flags yet for the medical community either. Traditional ‘physical’ abusers (ie broken bones, etc) often rotate ERs, so as not to draw attention to themselves.

  6. Susan Apr 09 at 4:34 pm Reply Reply

    I’m a therapist and I’ve worked with ‘at-risk’ kids a lot in my career. Given the state of budgets, etc. right now, I don’t believe that child protective services is going to be able to do a whole lot about this situation. She’s likely to get triaged out because of the lack of specific evidence or direct harm. (but still call of course, because maybe they don’t live in a big city like I do and it’s totally worth a try).

    I would also take a second approach. Encourage the friend to seek therapy for her daughter… try the whole ‘this must be really frustrating for her to not have any solution and still be in pain’ ‘it would be good for her to have a place to talk about her stress about all this’. My hope is that in a quiet, safe place- if there IS something going on, the daughter will talk about it and that therapist will be mandated to report it. CPS generally responds more seriously to reports by ‘mandated reporters’ than by friends & family. But, yeah, call them too.

  7. anon Apr 09 at 5:08 pm Reply Reply

    I have a friend with Munchausen’s. Or, I should say had, because she died, and although none of us KNOW that it is because of something she did to herself…we all know. We all knew, and none of us knew what to do, so we did nothing. That is a very different situation, because she was harming herself, and who exactly do you notify about that? with M-by-P you can at least involve authorities. I know how hard it is to take your suspicions to the next level and actually do something about them, because even when you suspect it, saying it out loud makes you wonder if you’re being dramatic or hysterical. You’re not. Please say something.

  8. MR Apr 09 at 6:46 pm Reply Reply

    I agree with everyone else – you need to say something here. The way I look at it is this – M by P is not super common. This is a friend of yours, which means you are NOT going to just jump to rash conclusions. You have thought about this, and second and third guessed yourself. You are not thinking this is a light conclusion to arrive at. Which means the fact that you are thinking it means that there is something there definitely worth being checked. You are dealing with a CHILD. One who is potentially being harmed by the very person who is supposed to protect them. You need to report this. Just in case. Report it. Meanwhile, try to convince the mother to get herself and her daughter in counseling like pp said. And if nothing ever comes from it because the system is too busy, escalate it to the father. It may be enough to simply plant the seed so he looks into it. He has to already be aware that his wife has this tendency towards herself, but maybe he is just in denial about his child? I know it is risking your friendship to escalate this to the father, but it is potentially risking this child’s life by not doing so. Because someone just NEEDS to check and look into it. You don’t live close enough to do this yourself, but you CAN instigate someone else to look into it.

  9. Suzy Q Apr 09 at 7:51 pm Reply Reply

    Yes, to all of what Amalah said. Also, it sounds like the mother has  a hefty case of Munchausen’s herself.  That kid needs to be saved.  

    Good luck with this very tough problem, Concerned Friend.  Please make that call and know you have support as you do so.  I also hope you find peace (and no guilt!) with the decision to do what’s necessary.

  10. David Apr 09 at 8:57 pm Reply Reply

    I’m totally creeped out. And I in no way envy you for being put in that position. You hear these stories (and many others) and never think you personally would ever have to deal with such a horrible and surreal situation. As unfortunate as the situation is I believe to act is the only true option as difficult as it may be. To stand aside and do nothing. I believe it was Edward Burke who said, “All that is necessary for evil to succeed, is for good men to do nothing” or something to that effect. I wish you the courage to do whats right.

  11. roo Apr 10 at 12:27 am Reply Reply

    I think Susan’s second approach, encouraging friend to take daughter to see a therapist, is really smart. It’s a course of open-ended treatment, which might appeal to someone with Munchausen’s (so she might actually do it, is what I mean), and it puts the daughter in a position to help herself if no one else can.

  12. AnonymousForToday Apr 10 at 9:45 am Reply Reply

    If the mom suffered from what you suspect is Munchausen’s and the issue is allegens with a tweenager, it is also possible that the daughter is not cooperating with the anti-allergen regime, either because she too enjoys the attention from being “sick” or out of defiance or denial that she really needs to stick to the anti-allergen regime. Personally, when I was a kid I was anxious and wanted to stay home from school, but my mom would only let me if I was “actually sick” ie fever or throwing up. I learned to make myself throw up so I could stay home, and it progressed to the point when being anxious made me throw up, no need to “make” myself anymore. It also went into a downward spiral of buliema, but that’s another story.Even as an adult I sometimes throw up if I’m under a lot of stress. I would highly recommend the suggesting therapy route, for both mom & daughter individually and together. You could also try suggesting the daughter go to a summer camp (they exist for kids with all kinds of condititons, so there may be one for kids with allergies) or to stay with another family member for some time in the summer to see if that helps with the condition – it would get her away from her mother and give a chance to see whether that helps the situation, if it is M or M by P

  13. Sarah Apr 10 at 11:47 am Reply Reply

    Also, something not considered here is a physical/psychological condition called amplified pain. It is often seen in type A teenage girls with stressed out/wacky parents-particularly moms. These kids turn their stress into physical ailments and the ailments (which can manifest as anything) come and go with the stress in their lives. Diagnosis is usually made through a psychologist or pediatric rheumatologist. I’m not an expert, but I’ve heard a lot about this syndrome. I’m just offering it as another way to look at the problem. Either way, counseling for the girl seems like a very good idea.

  14. Ashley Apr 10 at 2:10 pm Reply Reply

    I am a social worker and while this situation may be perfectly innocent, I think the most important thing you can do is go with your insticts. Your gutt is screaming that something is not quite right and you need to listen to that, even if in the end it means losing your friend. It always makes me so angry after abuse has been brought to light and people say, “I knew something seemed funny” or “I thought so” because if they had come forward they would have saved a child days, months, years of horror. I recently read a book on M by P and if anyone is interested in learning more about a woman who was raised in this environment you should check it out as well: Sickened: The True Story of a Lost Childhood http://www.amazon.ca/Sickened-True-Story-Lost-Childhood/dp/0553381970

    Good luck.

  15. Bella Apr 10 at 9:30 pm Reply Reply

    Also, remember that it’s CPS’s job to ‘prove’ these cases–you don’t have to KNOW before you call. However, if you don’t call, they have no idea that something needs to be investigated. Just do it.

  16. Christina Apr 12 at 10:48 am Reply Reply

    Ugh. You poor thing. Agree that you have to act. My social worker/PhD bestie has horrific stories about these moms too. She suggested another route: call the hospital directly and tell them. Due to confidentiality, they can’t even confirm or deny that they’ve treated her, but if you put the bug in their ear that you believe a little girl is being treated at their facility by a MP mom, they’ll make a note of it and ACT on it (legally they have to). So if you can find out several of the nearby hospitals or even doctor names, I’d call ASAP. You might need to be sneaky “hi friend, someone in the area needs a recommendation for a good ER/dr, since you’ve sadly had so much experience, where do you suggest?”
    Good luck!

  17. Christina Apr 12 at 10:49 am Reply Reply

    One more thing: trained friend thinks it’s highly unlikely the mom will consent to sending her daughter to therapy without her there. On some level, she KNOWS what she’s doing is wrong, and if the daughter is aware of it (which she might not even be), she wouldn’t risk her daughter having the chance to tell a professional. Just a thought.

  18. Kate Apr 13 at 3:57 pm Reply Reply

    I really think you should talk to the girl’s father before going to CPS. He’s in the best position to actually do something. Would it kill your friendship? Probably, but I really don’t see how your friendship would remain unaffected if you contact protective services without telling her. If the father doesn’t do anything and you continue to have concerns, then you can contact CPS.

  19. Lisa Apr 20 at 1:29 pm Reply Reply

    To Truly Concerned Friend:

    Please make sure that both the mother and the daughter are tested for Celiac Disease. I went 22 years as an undiagnosed Celiac, and I can’t tell you how many different people accused either me or my mother of making things up or blowing them out of proportion. Celiac can cause nausea, vomiting, rashes … all of the things mentioned and many, many more. Many doctors won’t test for it because they believe it is rare, but it’s not all that rare in the US.

    For more information on Celiac Disease: http://www.mayoclinic.com/health/celiac-disease/DS00319

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