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Letters 11-17-2014

by Dr. Buono in the November 10 Northern Express. While I applaud your enthusiasm embracing a market solution for global climate change and believe that this is a vital piece of the overall approach, it is almost laughable and at least naive to believe that your Representative Mr.

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Sickened: Shedding Light on the Incomprehensible Munchausen Disorder

Nancy Sundstrom - November 20th, 2003
2003 has been a year packed with revealing autobiographies like “A Million Little Pieces“ and “Dry“ that have not been for the faint of heart. One of the very latest is Julie Gregory‘s horrifying and unforgettable “Sickened: The Memoir of a Munchausen by Proxy Childhood.“ If you can get through it without becoming ill yourself (and with good reason), you‘ll find that this first-of-its-kind memoir is a triumph of words and spirit, and very much worth the effort.
Munchausen by proxy disease (MBP) has to be one of the most unfathomable and bizarre forms of mental illness around, and the fact that relatively little is still known about it speaks to that. Formally defined as an illness around 1950, MBP is a psychological disorder in which caretakers, usually female and themselves the victims of traumatic abuse, “make an otherwise healthy child sick“ as a way of gaining attention and approval for themself. Named after an 18th-century aristocrat famous for his outrageous stories, Munchausen has been so difficult to comprehend because one simply has a hard time believing that a parent could violate and terrorize their child in such a bizarre manner.
It may be more understandable now, thanks to Gregory‘s courageous and unflinching book. A southern Ohio native, she is a graduate student in psychiatry at Sheffield University, England, and has become an expert writer and spokesperson on MBP and an advocate in MBP cases. Her knowledge on the subject is impressive from an academic standpoint, but her personal experience with it is part of what makes this book so extraordinary.
From early childhood, Gregory was continually X-rayed, medicated, and operated on, because by doing so, her mother, Sandy, found a form of attention she desperately craved. Sandy was the victim of physical and sexual abuse as a child, and the rest of her life wasn‘t much of an improvement, including being widowed and then remarrying a disturbed Vietnam veteran, but deeper, darker and even more disturbing forces were at work when she began to subject her daughter to one of the most hideous forms of child abuse known to humankind.
In the first chapter, Gregory sets the stage for a tale that will take turn after horrific turn as the innocence of childhood is stripped from her as a result of her mother‘s sick obsession with sickness:

“For starters, I was a sick kid. Beanpole skinny and as fragile as a microwave souffle, I bruised easy and wilted in a snap. Kids in school used to walk straight up to me and ask point-blank if I was anorexic. But I wasn‘t; just sick. And Mom bent over backwards trying to find out what was wrong with me. It wasn‘t just that I had a heart problem. It was everything rolled into one, bleeding together with so many indistinguishable layers that to get to the root of it was impossible, like peeling off every transparent layer of an onion, and when I got old enough to peel the onion myself, every layer made me cry.
I was conceived in the sickly womb of a sickly mother -- who starved herself and in turn starved me. She was highly anemic and blind with toxemia at the time of my birth -- the result, she explained, of high blood pressure cutting off the circulation to her eyes. I was pushed into this world premature at three pounds seven ounces, an embryonic little bird, glowing translucently, and when they slapped me I didn‘t even yowl. They thought I was dead. The doctor, holding my bluish body upside down by the ankles, took one look at me and said, “My, what big feet she has.“ And then I was ushered into an incubator where I lay, as all embryonic creatures do, waiting to hatch into the real world, outside the bubble. After that, my health only balanced precariously on the edge of a “Let‘s get to the bottom of what‘s wrong with this kid“ kind of existence.
There were early nose-‘n‘-throat flare-ups, loud belching that defied my delicate appearance, pesky and persistent migraines, swollen tonsils that fluttered a plea for removal whenever I said “Ahhh,“ a deviated septum blamed for my mouth hanging open to breathe, and elusive allergies that forever deprived me of sustenance from the four basic food groups. As we got closer to pinning down my mysterious illness in the cardiology department, Mom moved into micromanaged health care with the logistical vigor of a drill sergeant.
“Look, dammit, this kid is sick, all right? Just look at her. And so help me God, if she dies on me because you can‘t find anything wrong with her, I‘ll sue you for every cent you got.“ Mom‘s face was long, her eyes diving into slits, and she had that little white blob of thick spit that always played on her bottom lip whenever she got upset. Her voice trailed after any doctor who said no more tests could be done, stalked him down the corridor, sliced through the silence of the hallway.
“J---- C-----,“ she hissed, returning to the examining room, “I cannot believe that incompetent son of a (expletive).“
“Don‘t worry, Mom. It‘s okay. We‘ll go find another one.“
This is how I offered reassurance, by telling her we‘d just keep going.
“Look, I‘m trying to help you with this, sacrificing my life to find out what the hell is wrong with you. So stop (expletive) it up when we get in here by acting all normal. Show them how sick you are and let‘s get to the bottom of this, okay?“
“Okay.““

There was little Sandy wouldn‘t and didn‘t subject her child to, from forcing her to eat matches to suggesting she go through open-heart surgery. Julie becomes an unwitting accomplice in a scheme that grew increasingly more bizarre and out of control, and her documentation of the extent to which she was willing to sacrifice herself and her health to win her mother‘s love and approval is nothing short of heartbreaking. Equally jawdropping is that all of this went virtually unnoticed by scores of doctors and medical professionals. In the end, it would be Gregory who would save herself (and the life of a girl whom Sandy chose to replace Julie) begin the healing process by realizing what had been wreaked by her mother‘s madness.
For all the terror and trauma here, there is also stubborn streak of humor that Gregory refuses to let go of, though the ultimate triumph of her story is that she makes the syndrome comprehensible and there is very little of a victim‘s mentality at play in her candid, no-nonsense writing. “Sickened“ is an important work for several reasons, especially since it will no doubt turn a bright spotlight on a form of abuse that is - or has been - ignored, overlooked or misdiagnosed. By sharing her life‘s tragedy, Gregory might just be responsible for saving even more lives.

 
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