Home | Business News | Browse by Publication | F | Families, Systems & Health

Munchausen by mommy.

Article Excerpt
Munchausen's Syndrome by Proxy is hard to diagnose and treat. The patient harms a defenseless person who is in his care, usually a baby or a child, in order to receive the attention the parent requires. Such a parent makes his child ill, introduces his body to various dangers, and with much concern and sacrifice brings him in for medical treatment, accompanying it all patiently, lovingly and anxiously. All the while, the caregiver is making sure to sabotage the healing and cause further harm. This syndrome is a challenge to family physicians, Internists and Pediatricians, since only the continuity of care of these families may reveal the dangerous syndrome and prevent its harmful outcomes. In this case report, Sarah, the loving mother of Joy, continuously damages her daughter's health and exposes her to the dangers of sophisticated medical interventions. Only careful inspection by the medical teams, dialogue and co-operation can bring to an end the harmful behavior of joy's mother.

Keywords: Munchausen's Syndrome by Proxy, continuity of care, health care system, health-care professionals' communication, community-hospital collaboration

**********

Sarah gave birth to her fourth child, Joy, on Passover eve. Thirty-two weeks pregnant, she endured contractions throughout a long day of cleaning. The contractions could not be stopped, and Joy was born prematurely. There was great joy over the girl's birth. Joy spent several weeks in the neonatal intensive care unit without complications, after which she was sent home.

Worrisome signs appeared after a few weeks. One night, Sarah urgently summoned the family physician for a home visit. "Joy became suddenly stiff in my hands!" Sarah shouted hysterically. Her description included all the symptoms of near sudden infant death syndrome: apnea, turning blue, eye rolling. "I was sure the child had died," Sarah added. On examination, the child appeared relaxed, smiling, with no shortness of breath or other symptoms of concern. However, the mother's account obligated an immediate admission to the pediatric inpatient unit.

It was to be the first in a series of prolonged and difficult hospitalizations. Joy's condition went from bad to worse. She underwent an extensive examination, with every positive finding leading to yet another test. She contracted multiple illnesses because of infectious disease exposure during her extended stays in the pediatric ward. Sarah devotedly stayed by her bed, sometimes for days and nights without a break. She did not go home to change clothes or shower. She eagerly absorbed the doctors' opinions and communicated all of the various diagnoses and ideas to the other doctors. She could pronounce the longest Latin words and fluently describe any abnormalities discovered in Joy's invasive imaging tests and the additional clarification they each required.

Dr. K, Joy's family physician, became concerned about these dynamics at this early stage. When Dr. K visited Joy in the hospital to recruit helpers for Sarah, Sarah refused. Dr. K suspected Joy's condition had some iatrogenic origins. However, the inpatient medical staff focused on the pathological test results and the mother's inner conviction. Dr. K did not share her suspicions because she did not have any proof.

In the context of the extremely busy and chaotic medical setting, Sarah became the liaison between the various specialists. The specialists began to rely on her, essentially making Sarah part of the team. Sarah explained previous professionals' conclusions to each newcomer. She and the medical providers engaged in the intellectual exercise of differential diagnosis together. She suggested her own ideas, tending to emphasize rare, serious diagnoses. Sarah focused on the limitations of each normal test result, insisting that tests that occurred under less-than-optimal conditions be repeated. She constantly sought more problems.

Sarah blossomed. She became the resident expert in the pediatric ward, her second home. Other mothers consulted with her. She knew it...

View this article FREE - Now for a Limited Time, try Goliath Business News
Free for 3 Days!