By Jae-Ha Kim
Chicago Sun-Times
January 23, 2004
At age 4, Mary Bryk began to suspect there was something seriously wrong with her mother. As Bryk recalls, her mother would meticulously tie Bryk’s hands together and bind her leg to a high chair. Then, she would strike the child’s foot with a hammer.
“My mom was a nurse and would constantly tell me she was doing treatments and that the doctor knew what she was doing,” says Bryk, now 44. “But even at that age I knew something wasn’t right. When she fractured my hip while I was hospitalized, that’s when it hit me that what she was doing wasn’t normal.”
This went on until Bryk was 10, when she threatened to tell her teacher and doctor what was going on. Soon after, her mom set her sights on Bryk’s 3-year-old brother.
It’s a crime that seems unspeakable — parents, almost always women, deliberately harming their children to gain attention for themselves. But Munchausen’s by proxy, explored on television’s “Law and Order” and referenced in the movie “The Sixth Sense” and rap-star Eminem’s song “Cleaning Out My Closet,” has struck close to home with the case of Tracie Fleck, a 33-year-old Highland, Ind., woman recently charged with repeatedly contaminating her 21-month-old daughter’s IV tube.
“It sounds like a fancy term, but what people have to understand is that Munchausen’s by proxy is not a disease,” says Bryk, a Detroit nurse who has published papers on the topic. “It’s child abuse. They’re not psychotic people who can’t control themselves. They know what they’re doing. That’s why these perpetrators need to be litigated.”
The typical Munchausen’s perpetrator is female, usually the mother of the victim, who enjoys the sympathy and attention lavished on her by doctors, family and friends. Fleck reportedly admitted to Indianapolis authorities that the father of the baby came around more when their child was sick.
“These cases rarely make it to criminal court, where they belong,” says Dr. Marc D. Feldman, whose book about Munchausen’s by proxy, Playing Sick (Brunner-Routledge), will be in stores this May. “Unfortunately they’re usually adjudicated in family court, where the mother’s parental rights may be terminated.
“It’s a deal with the devil that the judge and police make, the theory being that as long as mom has lost custody, that’s punishment enough. In reality, no, that’s not enough. The fact that many of these children aren’t verbal shouldn’t mean they should be deprived of their rights.”
When he testifies in court, Feldman says, he advises prosecuting attorneys against using the “M” word.
“Munchausen’s by proxy sounds provocative and exotic,” he says. “The most important point to get across is, it’s a form of child abuse. It’s not a mental disorder. It’s a behavior. They make a willful decision to abuse a child, and when they’re caught, they lash out at others.
“I know of convicted perpetrators who have essentially used terrorist tactics to try to stop us from testifying. I’ve been the victim of death threats. They know exactly what they’re doing.”
Women account for 95 percent of Munchausen’s crimes. Experts characterize them as fairly anonymous, often well-respected women who appear to be role-model moms who bask in the attention their sick child brings them.
Of course, most aren’t seeking the kind of outraged publicity directed at Fleck, who is scheduled to be tried on March 15 on four felony counts of aggravated battery and neglect of a dependent. And while her daughter’s condition is improving, the little girl may have a lifetime of difficult coping ahead of her.
“I forgave my mother a long time ago — I had to in order to move on with my life — but I don’t stay in touch with her,” says Bryk, who has two children of her own. “I know that she’s still alive and may have Alzheimer’s, so she can now honestly say she doesn’t remember hurting me. That’s convenient for her.
“When I had my first baby, I sought therapy. I knew I could never harm my own child. But I didn’t have that overwhelming feeling of love and protection that most mothers get. I had never had that and worried I wouldn’t be a good mother.”
Syndrome Facts and Figures
Munchausen’s by proxy takes its name from Baron von Munchausen, an 18th-century German who enjoyed spinning outrageous tales. Though he never made other people sick, his name was misappropriated to describe the syndrome. Here are some more facts:
*** The United Kingdom’s Roy Meadow identified Munchausen’s by proxy in 1977. “Munchausen’s” refers to harming oneself to gain attention; “by proxy” means one is harming another.
*** Dr. Marc D. Feldman estimates there are more than 1,200 new cases of Munchausen’s by proxy annually in the United States.
*** 75 percent of the perpetrators are the mothers of the victimized children.
*** Of the remaining 25 percent, 20 percent are other women, often grandmothers, stepmothers or day-care workers. The other 5 percent are men, usually the father.
Warning Signs
Many mothers who harm their children do so when they’re alone. Pediatrics magazine reported that one hospital in Atlanta installed video cameras in rooms where 41 children had unexplainable illnesses. It turned out that 23 of them were being hurt by their mothers, whose crimes ranged from attempted suffocation to switching medicines.
Dr. Marc D. Feldman points out signs that can alert doctors or families to a problem:
NO. 1: Every episode of the illness begins when the mother has been alone with the child. Mothers are still the primary caregivers, so to some extent it’s natural for them to be the ones to notice symptoms. However, if the child is having repeated episodes only in the presence of the mother, that creates suspicion.
NO. 2: Multiple children in a family have had unexplained illnesses.
NO. 3: Symptoms fail to respond to appropriate treatments. Bacteria die when the appropriate antibiotic has been administered. If symptoms continually persist or recur, it could be Munchausen’s by proxy.
